Sometimes there is confusion over the usage of the term “controllers” in the treatment of asthma.

The term “controllers” can refer to the long-acting beta agonists (LABAs). But sometimes it is used to refer to both the LABAs and the anti-inflammatory drugs such as corticosteroids. As the LABAs and anti-inflammatory drug have different roles in asthma treatment, the term “preventers” can be used to refer specifically to the anti-inflammatory drugs.

The situation can be further confused by the fact that LABAs are no longer used alone as controllers. They are now always prescribed together with corticosteroids, often in combination inhalers.  This is because the use of beta-2 agonists alone leads to beta-2 adrenoceptor tolerance and increased risk of asthma-related death. Concomitant use of a corticosteroid helps to reduce beta-2 adrenoceptor tolerance and treats the underlying inflammatory disease.

In our lectures, we will use the terminology as follows:

Preventers reduce swelling and inflammation in the airways, stopping them from being so sensitive and reducing the risk of severe attacks. Thus they prevent the risk of recurrent attacks.

Controllers are long-acting beta-adrenoceptor agonists (LABAs) taken regularly at the same time daily to provide long-acting bronchodilation.

Relievers are short-acting beta-2 adrenoceptor agonists (SABAs) used “as needed” to relieve asthma attacks.