What is the recommended treatment for asthma?

From the Guidelines

The recommended treatment for asthma typically involves a stepwise approach based on symptom severity, with inhaled corticosteroids (ICS) forming the cornerstone of treatment for persistent asthma, as supported by 1. For mild intermittent asthma, short-acting beta-agonists (SABAs) like albuterol (2 puffs every 4-6 hours as needed) are used for quick symptom relief. Some key points to consider in asthma treatment include:

• For persistent asthma, ICS form the foundation of treatment, with medications like fluticasone (100-500 mcg twice daily) or budesonide (180-720 mcg twice daily) being commonly used, as noted in 1 and 1.
• As severity increases, combination therapy with ICS plus long-acting beta-agonists (LABAs) like fluticasone/salmeterol (Advair) or budesonide/formoterol (Symbicort) is recommended, as indicated by 1 and 1.
• For severe asthma, additional options include leukotriene modifiers (montelukast 10mg daily), tiotropium, or biologics like omalizumab for allergic asthma, as mentioned in 1 and 1.
• All patients should have an asthma action plan detailing medication use, trigger avoidance strategies, and when to seek emergency care, emphasizing the importance of patient education and self-management, as highlighted in 1. These medications work by reducing airway inflammation and bronchospasm, addressing the underlying pathophysiology of asthma characterized by chronic inflammation, airway hyperresponsiveness, and reversible airflow obstruction, as discussed in 1 and 1. Regular follow-up is essential to adjust treatment based on symptom control, ensuring that the treatment plan is tailored to the individual patient's needs and response to therapy, as supported by 1 and 1.

From the FDA Drug Label

Wixela Inhub® is a combination product containing a corticosteroid and a long-acting beta2-adrenergic agonist (LABA) indicated for: • Twice-daily treatment of asthma in patients aged 4 years and older. For oral inhalation only. • Treatment of asthma in patients aged 12 years and older: 1 inhalation of Wixela Inhub® 100/50, Wixela Inhub® 250/50, or Wixela Inhub® 500/50 twice daily. • Treatment of asthma in patients aged 4 to 11 years: 1 inhalation of Wixela Inhub® 100/50 twice daily.

The recommended treatment for asthma is a combination product containing a corticosteroid and a long-acting beta2-adrenergic agonist (LABA), such as Wixela Inhub®, which should be taken twice daily. The specific dosage depends on the age and severity of the patient's asthma. For patients aged 12 years and older, the dosage is 1 inhalation of Wixela Inhub® 100/50,250/50, or 500/50 twice daily. For patients aged 4 to 11 years, the dosage is 1 inhalation of Wixela Inhub® 100/50 twice daily 2.

Alternatively, montelukast (PO) can be used for the chronic treatment of asthma. However, it is not indicated for the reversal of bronchospasm in acute asthma attacks. Patients should be advised to take montelukast daily as prescribed and to have appropriate rescue medication available 3.

From the Research

Asthma Treatment Overview

• Asthma treatment typically involves a combination of medications and lifestyle changes to manage symptoms and prevent exacerbations 4, 5.
• The goal of treatment is to achieve and maintain control of asthma symptoms, as well as to minimize the risk of future exacerbations 6, 7.

Medication Options

• Inhaled corticosteroids (ICS) are considered the most effective anti-inflammatory treatment for asthma, and are often used as the first line of treatment 5, 6.
• Long-acting beta2-agonists (LABAs) can be added to ICS therapy to provide additional bronchodilation and symptom control 4, 5.
• Leukotriene receptor antagonists (LTRAs) can be used as an alternative to LABAs, or as an add-on therapy to ICS 8.
• Combination inhalers that contain both ICS and LABA can provide convenient and effective treatment for patients with moderate to severe asthma 5, 7.

Treatment Strategies

• The stepwise approach to asthma treatment involves starting with low-dose ICS and gradually increasing the dose or adding additional medications as needed to achieve control 6.
• For patients whose asthma is uncontrolled with low-dose ICS, addition of alternative therapy instead of increasing the steroid dose is recommended 4.
• Stepping down treatment to a lower dose of ICS or switching to a different medication can be considered for patients who have achieved control 7.

Key Considerations

• The choice of treatment should be individualized based on the patient's specific needs and circumstances 4, 5.
• Patient education and adherence to treatment are critical components of effective asthma management 5, 7.
• Regular monitoring and follow-up are necessary to adjust treatment as needed and to prevent exacerbations 6, 7.