Clinical management of asthma in the 1990s. Current therapy and new directions.
Asthma is a serious global health problem affecting nearly 100 million people worldwide. Its rising prevalence and associated morbidity and mortality are of increasing concern. Traditionally, symptomatic control of bronchoconstriction with beta 2 agonists and theophylline has been the mainstay of therapy. However, during recent years, inflammation has been recognised as the predominant cause of reversible airway obstruction and airway hyperreactivity. As a result, the emphasis in treatment has shifted to the early use of inhaled corticosteroids to control airway inflammation. beta 2 agonists are best used on an as-needed basis for the relief of acute bronchoconstriction and for the prevention of exercise-induced asthma. Sustained release theophylline or an inhaled long-acting beta 2 agonist may effectively control nocturnal symptoms. Preliminary studies involving agents active in the 5-lipoxygenase pathway as preventive therapy are encouraging. Further studies are needed to define their role in the management of asthma.
Jain
P
P
Department of Pulmonary and Critical Care Medicine, Cleveland Clinic Foundation, Ohio, USA.
Golish
J A
JA
D001249:Asthma / Q000188:drug therapy* / Q000473:pathology; D004358:Drug Therapy / Q000639:trends; D006801:Humans