title: Japanese guideline for adult asthma.
abstract: Adult bronchial asthma (hereinafter, asthma) is characterized by chronic airway inflammation, reversible airway narrowing, and airway hyperresponsiveness. Long-standing asthma induces airway remodeling to cause an intractable asthma. The number of patients with asthma has increased, while the number of patients who die from asthma has decreased (1.7 per 100,000 patients in 2009). The aim of asthma treatment is to enable patients with asthma to lead a healthy life without any symptoms. A partnership between physicians and patients is indispensable for appropriate treatment. Long-term management with agents and elimination of causes and risk factors are fundamental to asthma treatment. Four steps in pharmacotherapy differentiate mild to intensive treatments; each step includes an appropriate daily dose of an inhaled corticosteroid (ICS), varying from low to high doses. Long-acting β(2) agonists (LABA), leukotriene receptor antagonists, and theophylline sustained-release preparation are recommended as concomitant drugs, while anti-IgE antibody therapy is a new choice for the most severe and persistent asthma. Inhaled β(2) agonists, aminophylline, corticosteroids, adrenaline, oxygen therapy, etc., are used as needed against acute exacerbations. Allergic rhinitis, chronic obstructive pulmonary disease (COPD), aspirin induced asthma, pregnancy, and cough variant asthma are also important factors that need to be considered.
authors.affiliation: Division of Respiratory Medicine and Allergology, Department of Medicine, Teikyo University School of Medicine, Tokyo, Japan. kenohta@med.teikyo−u.ac.jp
authors.forename: Ken
authors.initials: K
authors.lastname: Ohta
authors.forename: Masao
authors.initials: M
authors.lastname: Yamaguchi
authors.forename: Kazuo
authors.initials: K
authors.lastname: Akiyama
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Adachi
authors.forename: Masakazu
authors.initials: M
authors.lastname: Ichinose
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Takahashi
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Nishimuta
authors.forename: Akihiro
authors.initials: A
authors.lastname: Morikawa
authors.forename: Sankei
authors.initials: S
authors.lastname: Nishima
mesh_terms: D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000145:classification / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007564:Japan; D010353:Patient Education as Topic; D011247:Pregnancy; D015995:Prevalence; D012017:Referral and Consultation
chemical_list: D018927:Anti-Asthmatic Agents