From the Guidelines
For moderate persistent asthma, the recommended treatment is a combination of an inhaled corticosteroid (ICS) and a long-acting beta-agonist (LABA) 1.
First-line Treatment
The first-line treatment is an ICS and a LABA, which has been shown to provide excellent control of moderate persistent asthma in patients 12 years and older 1.
- I would recommend Fluticasone 250mcg and Salmeterol 50mcg, one inhalation twice daily, as the first-line treatment for moderate persistent asthma 1.
Additional Treatment
Additionally, a short-acting beta-agonist (SABA) such as Albuterol 90mcg, two inhalations as needed, can be used for acute symptom relief 1.
- For patients with allergies, an antihistamine or immunotherapy may also be considered 1.
Monitoring and Adjustments
It's essential to monitor asthma control and adjust medications as needed 1.
- Patients should be instructed to use their medications as prescribed and to seek medical attention if symptoms worsen or if they experience any side effects 1.
Key Points
- The combination of ICS and LABA is the preferred treatment for moderate persistent asthma 1.
- SABA can be used for acute symptom relief 1.
- Monitoring and adjusting medications as needed is crucial for effective asthma management 1.
From the Research
Medications for Moderate Persistent Asthma
The following medications are recommended for moderate persistent asthma:
- Inhaled corticosteroids (ICS) as the primary treatment for inflammation 2, 3, 4
- Long-acting beta2-agonists (LABA) as an add-on therapy to ICS for patients who are not well-controlled on ICS alone 2, 5, 3, 6
- Combination inhalers containing both ICS and LABA, such as fluticasone propionate and salmeterol, which provide convenient and effective treatment for both inflammatory and bronchoconstrictive components of asthma 2, 5
Dosages and Treatment Regimens
The following dosages and treatment regimens are recommended:
- ICS therapy at a low to medium dose, with the option to increase the dose if necessary 3, 4
- LABA therapy at a fixed dose, such as 50 microg of salmeterol, in combination with ICS 2
- Combination inhalers containing ICS and LABA, with dosages such as 100-500 microg of fluticasone propionate and 50 microg of salmeterol, taken once or twice daily 2, 5
- Regular monitoring of asthma control and adjustment of treatment as needed 4
Benefits of Combination Therapy
The benefits of combination therapy with ICS and LABA include:
- Improved asthma control compared to increasing the dose of ICS alone 2, 3
- Reduced frequency and severity of exacerbations 2, 5
- Convenient and effective treatment for both inflammatory and bronchoconstrictive components of asthma 2, 5
- Potential for improved patient adherence due to the convenience of a single inhaler 2