Table 1.

Step-down from fixed dose combination ICS/LABA

Study/Reference	Design	N	Duration	Population	Intervention	Primary outcome	Results	Comment
Koenig 2008 (36)	RDBPG	647	16 weeks	Uncontrolled on low-moderate ICS but controlled on FSC 100/50	Step-down to FP100, SAL 50 or Montelukast	PEF	Control deteriorated in all step-down groups
Fowler 2002 (42)	RDBPG	39	12 weeks	Mod-severe asthma	1000 BDP BID X 4 weeks then BDP 200 2 x daily or FSC 100/50 2x daily	PC20	Doubling dose improvement in MCT with FSC greater than either BDP dose	Lung function and QOL better on FSC vs BDP step-down
Bateman 2006 (43)	RDBPG	484	24 weeks	Moderate asthma, well-controlled	FSC 250/50 stepped down to FSC 100/50 vs FP 250	PEF	PEF lower in FP vs FSC	Symptoms, rescue albuterol and control better on FSC than FP
Godard 2008 (44)	RDBPG	473	6 months	Well controlled on FSC 250/50	Decrease to FSC 100/50 vs FP 250	PEF	FSC 100/50 similar to 250/50 but better than FP 250
Reddel 2010 (45)	RDBPG	82	13 months	FSC 500/50	500/50 vs FP 500 and down titrated every 8 weeks	Mean daily FP dose	No difference in mean daily dose FP but final dose lower in FSC	Question if patients were over treated

RDBPG=randomized, double blinded, parallel group; BDP=beclomethasone dipropionate; ICS=inhaled corticosteroid; BHR=bronchial hyperreactivity; CS=corticosteroids