Twenty-five statements on early initiation of fixed combination ICS/LABA treatment for asthma and COPD in primary and secondary care: consensus research by a modified Delphi process.

Background: Guidelines recommend the addition of a long-acting β2-agonist (LABA) for patients whose asthma is uncontrolled on inhaled corticosteroid (ICS) monotherapy. For COPD patients the addition of an ICS to a long-acting bronchodilator is recommended for symptomatic patients at high risk of exacerbations. We examined whether in real-life practice guideline recommendations may delay optimal timing for initiation of combination treatment.