title: Combination therapy of bronchial asthma.
abstract: For treatment of moderate and severe persistent asthma the National Heart Lung Blood Institute (NHLBI) Guidelines offer the alternative of moderately high doses of inhaled corticosteroids alone or a lower dose of inhaled corticosteroids combined with a long-acting bronchodilator. Three classes of drugs qualify for the combination with inhaled corticosteroids. They are long-acting beta-agonists, leukotriene receptor antagonists, and sustained-release theophylline. Each class of drug has been shown, when combined with inhaled corticosteroids, to provide equal or better asthma control than a higher dose of inhaled corticosteroids alone. Direct comparisons indicate that, of the three classes, the long-acting beta-agonists are the most effective. Furthermore, initial concerns regarding their masking airway inflammation appear to be unfounded, because when combined with inhaled corticosteroids, the long-acting beta-agonists further decrease both the frequency and the severity of asthma exacerbations and appear to have some modulating effect on airway inflammation.
authors.affiliation: National Jewish Medical and Research Center, 1400 Jackson St., Denver, CO 80206, USA.
authors.forename: H S
authors.initials: HS
authors.lastname: Nelson
mesh_terms: D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use*; D000318:Adrenergic beta-Agonists / Q000008:administration & dosage / Q000627:therapeutic use; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy*; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D003692:Delayed-Action Preparations; D004359:Drug Therapy, Combination; D006801:Humans; D020024:Leukotriene Antagonists; D013806:Theophylline / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D000305:Adrenal Cortex Hormones; D000318:Adrenergic beta-Agonists; D018927:Anti-Asthmatic Agents; D001993:Bronchodilator Agents; D003692:Delayed-Action Preparations; D020024:Leukotriene Antagonists; D013806:Theophylline