What action should be taken regarding LABA when stepping down therapy?

In the context of managing asthma or COPD, it is important to maintain effective control of the patient's symptoms while minimizing the risk of exacerbations. When stepping down therapy, the use of Long-Acting Beta-Agonists (LABA) in combination with inhaled corticosteroids (ICS) is generally recommended to remain unchanged.

LABAs play a crucial role in providing bronchodilation over an extended period, which helps to control nighttime symptoms and improve overall lung function. They are particularly effective when used in conjunction with ICS, as they help to enhance the anti-inflammatory effects of corticosteroids and improve control of persistent symptoms. Consequently, keeping the LABA unchanged during a step-down phase ensures that any decrease in medication does not lead to a resurgence of asthma or COPD symptoms.

In situations where therapy is adjusted, it's critical to assess the patient's overall control of their condition. Adjustments should be made thoughtfully to prevent any potential deterioration of their respiratory status, and removing a LABA prematurely may lead to an increased risk of worsening symptoms or exacerbations.