Approximately 45% of patients with asthma in the United Kingdom are receiving step 3 or higher therapy,1 most commonly inhaled corticosteroids (ICSs) and long-acting β2-agonists (LABAs). The 2016 Global Initiative for Asthma (GINA) guidelines propose a cycle of assessment, stepwise adjustment of treatment, and review of response to ascertain the lowest treatment to achieve control.2 In addition, the US Food and Drug Administration advocates stopping use of LABAs once asthma control is achieved and maintained and switching to ICS monotherapy.
Jabbal, S., Manoharan, A., Anderson, W., Lipworth, J., & Lipworth, B. (2016). Real-life effect of long-acting β2-agonist withdrawal in patients with controlled step 3 asthma. Annals of Allergy, Asthma & Immunology, 117(4), 430-431. https://doi.org/10.1016/j.anai.2016.07.022