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Safety of Long-acting Beta-agonists (LABA) in Asthma

A literature review published by Medscape looked at the safety of long-acting β-2 agonists (LABA) as mono- or add-on therapy to inhaled corticosteroids.

The 2 studies which showed an increased mortality with LABA allowed their use as monotherapy.

Currently, it is uncertain if the increased mortality is due to rare susceptibility to LABA or is a consequence of LABA monotherapy. The LABA monotherapy can potentially control the signs and symptoms of asthma while masking inflammation.

Hypothesis for LABAs' adverse effects:

M
Monotherapy
Masks inflammation
Mortality increase

Asthma classification and treatment for each stage. See more Allergy and Immunology mind maps here.

Update from Thorax 2012: Clearing the air: LABA/ICS reduce asthma hospitalizations, not associated with life-threatening events and deaths http://goo.gl/TesRp

References:

Safety of Long-acting Beta-agonists in Asthma: A Review. John Oppenheimer, MD; Harold S. Nelson, MD. Current Opinion in Pulmonary Medicine and Medscape, 03/2008.
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Risk of asthma exacerbations: Relative to SABA-only therapy, LABA use is associated with a lower risk of ED visit http://goo.gl/4sDc9
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Note: The photo on the right shows a Seretide-labeled metered-dose inhaler (MDI). Seretide is the trademark for salmeterol in Europe.