title: Asthma in adults.
abstract: BACKGROUND
  About 10% of adults have suffered an attack of asthma, and up to 5% of these have severe disease that responds poorly to treatment. Patients with severe disease have an increased risk of death, but patients with mild-to-moderate disease are also at risk of exacerbations. Most guidelines about the management of asthma follow stepwise protocols. This review does not endorse or follow any particular protocol, but presents the evidence about specific interventions.
  
  
  METHODS
  We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments for chronic asthma? We searched: Medline, Embase, The Cochrane Library, and other important databases up to April 2010 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
  
  
  RESULTS
  We found 54 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
  
  
  CONCLUSIONS
  In this systematic review we present information relating to the effectiveness and safety of the following interventions: adding anti-IgE treatment; beta(2) agonists (adding long-acting inhaled beta(2) agonists when asthma is poorly controlled by inhaled corticosteroids, or short-acting inhaled beta(2) agonists as needed for symptom relief); inhaled corticosteroids (low dose and increasing dose); leukotriene antagonists (with or without inhaled corticosteroids); and theophylline (when poorly controlled by inhaled corticosteroids).
authors.affiliation: Department of Medicine and Research, Fundacion Cardioinfantil Instituto de Cardiologia, Bogota, Colombia.
authors.forename: Rodolfo J
authors.initials: RJ
authors.lastname: Dennis
authors.forename: Ivan
authors.initials: I
authors.lastname: Solarte
authors.forename: Gustavo
authors.initials: G
authors.lastname: Rodrigo
mesh_terms: D000280:Administration, Inhalation; D000284:Administration, Oral; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use; D000318:Adrenergic beta-Agonists / Q000008:administration & dosage / Q000627:therapeutic use; D000328:Adult; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000888:Antibodies, Anti-Idiotypic / Q000008:administration & dosage / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy* / Q000453:epidemiology; D019317:Evidence-Based Medicine; D006801:Humans; D020024:Leukotriene Antagonists / Q000008:administration & dosage / Q000627:therapeutic use; D013806:Theophylline / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D000305:Adrenal Cortex Hormones; D000318:Adrenergic beta-Agonists; D018927:Anti-Asthmatic Agents; D000888:Antibodies, Anti-Idiotypic; D020024:Leukotriene Antagonists; C026408:anti-IgE antibodies; D013806:Theophylline