Combination of LABA + Inhaled Glucocorticoid Safe in Asthma

THURSDAY, June 28, 2018 — Compared to treatment with an inhaled glucocorticoid alone, combination therapy with a long-acting β2-agonist (LABA) and an inhaled glucocorticoid is not associated with a significantly higher risk of serious asthma-related events, according to a study published online June 27 in the New England Journal of Medicine.

William W. Busse, M.D., from the University of Wisconsin School of Medicine and Public Health in Madison, and colleagues performed a combined analysis of four trials comparing an inhaled glucocorticoid plus a LABA with an inhaled glucocorticoid alone in adolescents and adults with asthma.

The researchers identified three asthma-related intubations (two in the inhaled-glucocorticoid group, one in the combination therapy group) and two asthma-related deaths (both in the combination-therapy group) in four patients among the 36,010 patients in the intention-to-treat study. In a secondary analysis of serious asthma-related events, 0.6 percent of 18,006 patients in the inhaled-glucocorticoid group and 0.66 percent of 18,004 patients in the combination-therapy group had at last one composite event (relative risk in the combination therapy group, 1.09; 95 percent confidence interval, 0.83 to 1.43; P = 0.55); 11.7 and 9.8 percent, respectively, had at least one asthma exacerbation (relative risk, 0.83; 95 percent confidence interval, 0.78 to 0.89; P < 0.001).

“Combination therapy with a LABA plus an inhaled glucocorticoid did not result in a significantly higher risk of serious asthma-related events than treatment with an inhaled glucocorticoid alone but resulted in significantly fewer asthma exacerbations,” the authors write.

Several authors disclosed ties to the pharmaceutical and medical device industries.

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Posted: June 2018

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