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In their review on the safety of long-acting β2-agonists in asthma, Rodrigo et al 1 report that severe asthma-related complications were more frequent in patients receiving formoterol 24 μg twice daily (0.9%) than in those receiving formoterol 12 μg twice daily (0.4%) or placebo (0.2%) in a multicentre randomised trial.2 The original study reports different percentages of asthma-related complications in the treatment groups (table 1), and both serious asthma exacerbations and a combined outcome including serious asthma exacerbations, asthma-related discontinuations and emergency visits for asthma did not show statistically significant differences between the treatment groups.2 Consequently, the statement by Rodrigo et al 1 that higher doses of formoterol are associated with an increase in serious asthma exacerbations is disputable. Concerns about the safety of long-acting β2-agonists therapy are a matter of ongoing discussion, and a recently promoted FDA study3 may hopefully clarify the risk associated with the regular use of long-acting β2-agonists for the treatment of asthma.
Competing interests None.
Provenance and peer review Not commissioned; internally peer reviewed.