The challenge of mild persistent asthma.
OBJECTIVE
To review the current data and treatment options for mild persistent asthma.


METHODS
A MEDLINE search was performed for relevant articles.


METHODS
The expert opinion of the author was used to select studies for inclusion in this review.


RESULTS
Current data suggest that asthma severity is determined early in life and that disease progression may not occur outside early childhood. Furthermore, no therapy has been demonstrated to clearly prevent or reverse structural airway changes in patients with persistent asthma. Thus, the primary goal of asthma therapy is to prevent disease exacerbations rather than to halt disease progress, at least in patients past early childhood. Published reports of severe exacerbations in patients with reported mild asthma may actually reflect inclusion of patients with more severe forms of the disease who were inappropriately classified in terms of asthma severity.


CONCLUSIONS
Unlike the case for moderate and severe asthma, where regular therapy with inhaled corticosteroids is clearly the treatment of choice, clear guidelines for treating patients with mild persistent asthma have not been established. Patients with mild disease without severe exacerbations may require only the minimum therapy necessary for disease control.
Irani
Anne-Marie
AM
Department of Pediatrics and Internal Medicine, Virginia Commonwealth University Health Systems, Richmond, Virginia 23298, USA. airani@vcu.edu
D000318:Adrenergic beta-Agonists / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology; D002648:Child; D002986:Clinical Trials as Topic; D004205:Cromolyn Sodium / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D020024:Leukotriene Antagonists / Q000627:therapeutic use; D017835:Nedocromil / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D013806:Theophylline / Q000008:administration & dosage / Q000627:therapeutic use
D000318:Adrenergic beta-Agonists; D018927:Anti-Asthmatic Agents; D005938:Glucocorticoids; D020024:Leukotriene Antagonists; D017835:Nedocromil; D013806:Theophylline; D004205:Cromolyn Sodium