Insufficient control of asthma: increase the dose of inhaled steroids or add long-acting beta 2-agonists?
Internationally accepted treatment guidelines for bronchial asthma have established the early introduction of inhaled corticosteroids as a disease-modifying treatment, in addition to bronchodilator treatment as needed. In a small group of patients this approach does not lead to sufficient control of asthma. It is a matter of debate whether in this situation the dose of inhaled steroids should be increased or the bronchodilator treatment intensified by the introduction of long-acting beta 2-agonists. Advantages and limitations of both treatment strategies are discussed in the light of recent data. Guidelines for the use of long-acting beta 2-agonists are proposed.
Aubert
J D
JD
Pulmonary Division, University Hospital, Lausanne.
Quadri
F
F
Solèr
M
M
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage* / Q000009:adverse effects; D000318:Adrenergic beta-Agonists / Q000008:administration & dosage*; D001249:Asthma / Q000188:drug therapy*; D001993:Bronchodilator Agents / Q000008:administration & dosage; D003692:Delayed-Action Preparations; D006801:Humans; D012138:Respiratory Therapy
D000305:Adrenal Cortex Hormones; D000318:Adrenergic beta-Agonists; D001993:Bronchodilator Agents; D003692:Delayed-Action Preparations