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    Cheap is cheerful – and certainly adequate

    We are delighted to have a strong line-up of asthma papers this month. Our editors’ choice (see page 328) investigates the safety of long acting beta2 agonists (LABA) with and without inhaled corticosteroids. A recent audit in Thorax showed that LABA monotherapy is still depressingly common in the UK and it likely accounts for the mortality concerns that have fuelled several multimillion dollar FDA mandated studies of LABA safety. The authors used administrative health database records to compare asthma related hospitalisations (accepted as a proxy of mortality in the ongoing safety trials) in patients taking LABA and inhaled corticosteroids with those taking either drug alone. Patients taking LABA alone were 2–3 times more likely to be hospitalised compared to those taking inhaled corticosteroids alone. Reassuringly, those taking LABA with inhaled corticosteroids had no excess hospitalisation, although use of the latter for more than 75% of the year was required for full protection. Dare we suggest that this is an acceptable and much cheaper way of investigating LABA safety?

    A novel therapy travelling in Stephenson's Rocket?

    One great advantage …

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