EDITORIALS
Mechanisms of adverse effects of β-agonists in asthma
Department of Respiratory Medicine, National Heart and Lung Institute
Correspondence to:
Correspondence to Professor Sebastian L Johnston, Department of Respiratory Medicine, National Heart and Lung Institute, Imperial College London, Norfolk Place, London W2 1PG, UK; s.johnston@imperial.ac.uk
| The first 150 words of the full text of this article appear below. |
Short-acting β-agonist (SABA) drugs have been mainstays of asthma therapy for many decades and are recommended treatment at all levels of asthma severity, as they provide prompt relief of asthma symptoms through smooth muscle relaxation and, thereby, bronchodilatation. At all levels of asthma severity more severe than mild intermittent, SABAs are recommended to be taken as required for relief of symptoms in conjunction with inhaled corticosteroids (ICSs) taken as regular maintenance treatment. However, in mild asthma SABAs are recommended as monotherapy without concomitant ICS therapy, and in both mild and more severe asthma, greatly increased SABA use at times of asthma exacerbation is almost universal. Here we discuss the safety of inhaled β-agonist monotherapy in asthma and argue against the continued use of β-agonist monotherapy (both short and long acting) in the absence of concomitant ICS therapy in a combination inhaler.
Several epidemiological studies link overuse of SABA therapies at
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