Prevention of COPD flare-ups, reduced visits to their doctor, reduced hospital admissions and improved COPD symptoms (over a period of time) and quality of life, can be achieved by using devices containing a long acting beta agonist (LABA) or long acting muscarinic agent (LAMA) . Only short-acting agents will provide immediate relief of shortness of breath. It is very important for the patient and family to realize that they will not "feel better" immediately after using these long-acting agents, they are not expected to work that way. These have to be taken for months, all the time, even if they are feeling well, in order for the patient to benefit from them. They work to PREVENT COPD flare-ups as well as improve the range of COPD symptoms (when taken long term). So regular use of long-acting agents (LABAs/LAMAs/steroid-combination) will have these benefits:
Inhaled steroids, if used for patients with COPD are always given in combination with a LABA or a LAMA.
Inhaled steroids, for COPD have been shown to reduce COPD flare-ups (when added to a LABA or LAMA) and provide the same benefits as LABAs/LAMAs except they have not been shown to reduce hospital admissions. But regardless, to treat COPD, inhaled steroids are only given in a combination inhaler with a LABA/LAMA. Therefore, that combination inhaler, when used regularly, will provide the same benefit as the LABA/LAMA component (i.e. reduced hospital admission risk).
For asthma, inhaled steroids are always needed to reduce asthma exacerbation risk and control symptoms; LABAs can be added to an inhaled steroid.
Only patients with asthma would be prescribed a device containing a steroid only. Even patients with newly diagnosed or exercise induced asthma with very mild / infrequent symptoms need inhaled steroid (either daily or in combination with formoterol as a PRN).
Formoterol is a LABA with a fast onset, fast enough to be used PRN for asthma symptoms. LABAs also reduces asthma exacerbation risk and control symptoms. LAMAs are not generally used for asthma. For asthma it is important to note that exacerbation risk and control of symptoms are separate, in that patients can have relatively mild/infrequent symptoms but still have a risk of exacerbations (have a mortality risk). So for asthma, the benefits of inhaled steroid and LABAs are: