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Explanations: beta-2 agonists produce bronchodilation, but are not anti-inflammatory fomorterol has a rapid onset very similar to SABAs (within 5 minutes), but has the additional benefit of a ~ 3 fold longer (12 vs 4 hour) duration of action ICS reduces inflammation, which is the major cause for worsening of asthma Step Down Therapy When patients with asthma have symptoms that are well-controlled by a stable drug regimen for 3 to 6 months, it is recommended that controller medications be reduced in a step-wise manner to minimize potential adverse effects (especially corticosteroids), as well as expense and inconvenience