From the Guidelines
Asthma treatment typically involves a combination of long-term control medications and quick-relief medications.
Long-term Control Medications
The most effective long-term control medications are those that attenuate the underlying inflammation characteristic of asthma, such as:
- Inhaled Corticosteroids (ICSs), which are the most consistently effective long-term control medication at all steps of care for persistent asthma 1
- Long-acting b2-agonists (LABAs), which are used in combination with ICSs for long-term control and prevention of symptoms in moderate or severe persistent asthma 1
- Leukotriene modifiers, which can be used as alternative therapy for mild persistent asthma, but are not preferred compared to ICSs or LABAs 1
- Immunomodulators, such as omalizumab, which can be used as adjunctive therapy for patients with severe persistent asthma 1
Quick-relief Medications
Quick-relief medications are used to treat acute symptoms and exacerbations, and include:
- Short-acting b2-agonists (SABAs), such as albuterol, which are the treatment of choice for relief of acute symptoms and prevention of exercise-induced bronchospasm (EIB) 1
- Anticholinergics, such as ipratropium bromide, which can be used as an alternative bronchodilator for patients who do not tolerate SABAs 1
- Systemic corticosteroids, which are used for moderate and severe exacerbations to speed recovery and prevent recurrence of exacerbations 1
The goal of asthma treatment is to achieve and maintain control of persistent asthma, and the treatment approach should be stepped up or down based on the patient's response to treatment 1. It is also important to note that combination therapy, such as the addition of LABAs to ICSs, can be effective in achieving asthma control, especially in patients with moderate or severe persistent asthma 1.
From the Research
Treatment Options for Asthma
The treatment for asthma typically involves a combination of medications and lifestyle changes. The goal of treatment is to control symptoms, prevent exacerbations, and improve quality of life. Some of the treatment options for asthma include:
- Inhaled corticosteroids, which are the most effective medications for long-term asthma control 2, 3
- Short-acting beta2 agonists, which are preferred asthma reliever medications 3
- Long-acting beta2 agonists, which can be used in combination with inhaled corticosteroids for controller and reliever treatments 3, 4
- Leukotriene receptor antagonists, which can be used as add-on therapy for patients with mild to moderate asthma 2, 3
- Anticholinergics, which can be used as add-on therapy for patients with severe asthma 2, 4
Stepwise Approach to Treatment
Asthma treatment typically follows a stepwise approach, with treatment intensity increasing as symptoms worsen 3, 4, 5, 6. This approach involves:
- Assessing asthma severity and control at diagnosis and at subsequent visits
- Initiating treatment with inhaled corticosteroids and adjusting as needed
- Adding additional medications or increasing dosage in a stepwise fashion according to guideline-directed therapy recommendations
- Considering single maintenance and reliever therapy for adults and adolescents with asthma 3
Emerging Therapies and Personalized Treatment
New biological therapies and developments in biomarkers present opportunities for phenotype-specific interventions and personalized treatment for severe asthma 5. Subcutaneous immunotherapy may be considered for patients with mild to moderate allergic asthma, while biologic agents may be considered for patients with severe allergic and eosinophilic asthma 3.