When stepping up therapy for asthma, why is it advisable to use long-acting β-agonists (LABAs)?

Using long-acting β-agonists (LABAs) in asthma management is especially valuable because they work synergistically with inhaled corticosteroids (ICS). LABAs enhance the overall control of asthma by providing prolonged bronchodilation, which helps relieve airway constriction. When combined with ICS, LABAs can improve lung function, decrease symptoms, and reduce the frequency of exacerbations more effectively than either medication alone. This combination therapy is often necessary when asthma is not sufficiently controlled with inhaled corticosteroids alone.

While short-acting β-agonists (SABAs) provide immediate symptom relief, LABAs do not serve that purpose; rather, they are intended for maintenance treatment. Moreover, LABAs are not recommended as monotherapy without inhaled corticosteroids due to safety concerns and the potential for worsening asthma control. They also do not eliminate the need for rescue inhalers, as SABAs are still essential for acute symptom relief. Therefore, the combination of LABAs with inhaled corticosteroids offers a comprehensive approach to managing asthma effectively.