Combination of inhaled corticosteroid and a long-acting β-agonist

Spahn1 describes the long and winding road related to the controversies of the inhaled corticosteroid (IC) LABA combination. He states that the large studies demonstrating the safety of the combination are compelling.2–4 However, because those studies specifically excluded patients with previous life-threatening reactions, I want to draw attention to the observations my colleague and I previously reported in 2 boys, aged 10 and 15 years, with a previous history of life-threatening asthmatic exacerbations while receiving a LABA with an IC.

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