Treatment strategies in mild asthma.
OBJECTIVE
More than 10 years ago the category of mild asthma was split into mild intermittent and mild persistent asthma and maintenance therapy with low dose inhaled corticosteroids (ICS) was recommended for mild persistent asthma. The threshold for instituting regular ICS therapy was arbitrarily chosen, in the absence of clinical studies specifically addressing this issue.


RESULTS
The results of recent trials have questioned the assumption that all patients at the mild end of the asthma severity spectrum should be committed to regular anti-inflammatory treatment with inhaled corticosteroids. As a consequence, the identification of the relevant outcomes for the treatment of mild persistent asthma has become a matter of discussion, which has provided the rationale to test the efficacy and well tolerance of new strategies, other than guidelines-recommended regular low-dose ICS, for the treatment of mild persistent asthma.


CONCLUSIONS
Several approaches have been evaluated with some promising results, to include the combination of ICS and long-acting b2-agonists, oral leukotriene antagonists, and the intermittent or as-needed use of ICS in the absence of regular treatment. Conversely, little effort has been made to evaluate therapeutic options other than as-needed bronchodilation in mild intermittent asthma.
Papi
Alberto
A
Respiratory Medicine and Research Center on Asthma and COPD, University of Ferrara, S. Anna University, Hospital, 44100 Ferrara, Italy. ppa@unife.it
D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use; D000318:Adrenergic beta-Agonists / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D006801:Humans; D020024:Leukotriene Antagonists / Q000627:therapeutic use; D012720:Severity of Illness Index
D000305:Adrenal Cortex Hormones; D000318:Adrenergic beta-Agonists; D020024:Leukotriene Antagonists