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Long-acting beta 2-agonists. Role in primary care asthma treatment.

OBJECTIVE
To examine the efficacy of long-acting beta 2-agonists and their role in primary care asthma management and to review briefly the pharmacology of these agents.


QUALITY OF EVIDENCE
Most data presented were derived from randomized, double-blind, placebo-controlled trials. Studies were selected for relevance to asthma management in primary care.


MAIN FINDINGS
Long-acting beta 2-agonist use is associated with improvements in both objective and subjective measures of asthma control. At present no evidence suggests that long-acting beta 2-agonists have anti-inflammatory potential. While salmeterol has a longer duration of action than short-acting beta 2-agonists, its onset of action is slower. Salmeterol and formoterol, therefore, should not be used for relief of acute bronchospasm.


CONCLUSION
Long-acting beta 2-agonists could be useful for treating asthma in primary care, particularly for controlling symptoms of nocturnal asthma and exercise-induced asthma and for providing convenient maintenance therapy for patients who require regular use of short-acting beta 2-agonists despite concomitant use of optimal doses of inhaled anti-inflammatory medication.