Long acting beta-2 agonists in the treatment of asthma and their safety

Inhaled corticosteroids are the preferred primary long-term treatment for asthma. The first option in patients who are uncontrolled with inhaled steroids is adding long-acting beta-2 agonists. The addition of a long-acting beta-agonist to an inhaled corticosteroid has been accepted as effective therapy for almost two decades Despite the widespread use and their clinical benefit, controversy regarding their safety arose after their introduction. Concerns about the safety of long-acting beta-2 agonist therapy, has led to the appearance of multiple publications and recommendations. The evidence supports the use of long-acting beta-2 agonists plus inhaled corticosteroids in a single inhaler device to increase adherence and reduce the potential use of long-acting beta-2 agonists monotherapy. This review examines and commands on the available clinical data and safety concerns of long-acting beta-2 agonists use in patients with asthma.