OBJECTIVES: To compare baseline demographics of long-acting beta-agonist (LABA) step down in asthma patients taking fluticasone propionate-salmeterol via Diskus (FSC). METHODS: A retrospective observational study using pharmacy and medical claims data (Market Scan Commercial Database, January 1, 2006 to December 31, 2010). Subjects were included if they had : 1) ≥ 2 FSC prescription claims prior to the index (step-down) date; 2) ≥ 1 asthma claim [ICD-9-CM] codes 493.xx); 3) 12-64 years of age; and 4) continuously eligible for 12 months pre and post index. Subjects were excluded if they had: 1) COPD diagnosis (ICD-9 codes 491.xx, 492, xx, 496.xx), or 2) ≥ 1 prescription claim for anti-cholinergics or 3) receipt of higher dose FSC or another asthma controller other than FSC or ICS after the index. Step-down was defined as reduction in dose of FSC (lower dose FSC) or moving to ICS only without the LABA (ICS monotherapy). These two cohorts were matched 1:3 with subjects that remained on the starting FSC dose (same dose FSC).  Patient demographics included comorbidity, albuterol use, asthma-related health care utilization, number of controllers, number oral corticosteroids, number of physician visits, specialist visits, season, time to step-down and FSC fill rate.  Multivariate analysis was performed to determine the characteristics related to each step-down. RESULTS: Presence of a specialist visit [adjusted Odds Ratio (OR) 1.92, 95% CI 1.77-2.52 and OR 1.47, 95% CI 1.31-1.85] and more physician visits (OR = 1.16, 95% CI: 1.11-1.28, and OR, 1.17 95% CI 1.11-1.28) prior to step-down were significantly associated with step-down of therapy for both low dose FSC (n=1,459), and ICS monotherapy (n=1,775) respectively.  CONCLUSIONS: Subjects with close assessment of asthma disease and specialist care may be more likely to step-down from FSC therapy.