You need the CHAIN() around your code to make it work. If you have more than one key that needs to be sent, you need the CHAIN() command.
Looks like this:
MapKeyIO(&Joystick,H1U, CHAIN(R_CTL+USB[0x33],USB[0x60]));
A word of advice would be to use dx button for vital things like trimming, weapons and such, to avoid stuck keys and modifiers changing commands with multiple key presses. I only use keys for things like gear, flaps, etc. All combat related commands are directx buttons.