Combination of ICS and LABA appears to reduce severe asthma attacks

A Henry Ford Hospital study has found that using two types of common asthma medications in combination reduces severe asthma attacks.

Researchers say using long-acting beta-agonists (LABAs) in fixed-dose combination with inhaled corticosteroid (ICS) appear to reduce asthma attacks as well as or better than corticosteroids alone. Patient groups who had in greatest benefits were:

• Patients 18 and older
• African-American patients
• Male patients
• Patients with moderate to severe asthma

The study is believed to be the first to estimate actual patient use when assessing the effectiveness of these medications in reducing severe asthma attacks. Researchers analyzed data of 1,828 asthma patients who received an ICS/LABA combination or an ICS alone between January 2003 and December 2010.

The findings are published online in the Journal of Allergy and Clinical Immunology at http://www.jacionline.org/article/S0091-6749%2811%2902943-5/abstract

Researchers say the findings are a key development in asthma treatment involving LABAs as a potential therapy. The safety of LABAs by themselves as a therapy were called into question after a high number of deaths and serious asthma attacks were reported in the Salmeterol Multicenter Asthma Research Trial, forcing it to be abruptly stopped in 2003. In this study, African-American patients, in particular, fared worse than using a LABA inhaler as compared to placebo.

As a result, the U.S. Food and Drug Administration suggested limiting the use of LABAs to patients already taking an asthma controller such as an inhaled corticosteroid. A series of clinical trials are under way investigating the benefits of LABA in combination with ICS treatment, and results are not expected until 2017.

"Until those trials are completed, our study provides important interim evidence that a fixed-dose combination therapy can reduce asthma attacks," says Karen Wells, MPH, a Henry Ford researcher and the study's lead author.

Added Keoki Williams, M.D., MPH, associate director of Henry Ford's Center for Health Policy and Health Services Research: "We are especially encouraged by the benefits experienced by African-American patients. Our findings suggest that inhaled long-acting beta-agonists are broadly beneficial for treating asthma when they are simultaneously administered with an inhaled corticosteroid."