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For the past 2 decades, a combined regimen of inhaled corticosteroids (ICS) and long-acting β-agonists (LABAs) has been considered first-line therapy for asthma that is uncontrolled on ICS monotherapy. The combination reduces symptoms and exacerbations and improves lung function and quality of life. However, in an earlier large safety trial, LABAs were associated with asthma-related deaths, particularly among black patients (JW Gen Med Feb 17 2006); an unresolved issue is whether this association is mitigated when LABAs are used with ICS.
In this population-based, observational study from Michigan, 1828 asthma patients (age range, 12–56) who received either ICS alone or an ICS–LABA combination were followed for a mean of 2.1 years; the prima…