Formoterol asthma exacerbations

If asthma control is not optimal, conventional advice was to increase the ICS dose. However, it is now apparent, that the dose-response effect of ICS is rather flat, so that there is little improvement in lung function after doubling the dose of inhaled steroid. An alternative strategy is to add some other class of controller drug. Several studies have shown that the combination of ICS and salmeterol or formoterol was more effective than increasing the dose of inhaled corticosteroid in terms of lung function improvement, rescue /32-agonist use, symptom control, and frequency of mild and severe asthma exacerbations. 

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