Problems may also arise when maintenance dosing is withheld from people with more severe asthma, who generally require more medication for satisfactory control. Their feedback loop will achieve its equilibrium not only at a higher medication dose but also, as an unintended backlash, with more residual asthma symptoms. To avoid this, the loop will have to be recalibrated as asthma becomes more severe (eg, by increasing the steroid dose taken at each occasion). So for severe asthma, maintaining a daily maintenance dose, or even increasing it, may be preferable. Hopefully, the upcoming Pan-European Eurosmart study (http://clinicaltrials.gov; identifier NCT00463866), which compares two dose levels of regular treatment with a budesonide/formoterol association, both with extra inhalations as needed, will provide more insight.