From the Guidelines
Asthma treatments should prioritize inhaled corticosteroids as the foundation of care for persistent asthma, with the addition of long-acting beta agonists or leukotriene receptor antagonists as needed, based on the severity of symptoms and patient response. The goal of asthma treatment is to achieve and maintain control of symptoms, prevent exacerbations, and improve quality of life. According to the most recent guidelines 1, inhaled corticosteroids are the preferred controller medication for persistent asthma, as they have been shown to improve asthma control more effectively than any other single long-term control medication. For quick relief during asthma attacks, short-acting beta agonists (SABAs) like albuterol are used, typically 2 puffs every 4-6 hours as needed. Some key points to consider in asthma treatment include:
- Inhaled corticosteroids should be taken daily on a long-term basis to achieve and maintain control of symptoms
- Long-acting beta agonists can be added to inhaled corticosteroids for moderate to severe asthma, but should not be used as monotherapy
- Leukotriene modifiers like montelukast can be used as an alternative or adjunctive therapy for mild persistent asthma
- Proper inhaler technique and environmental trigger avoidance are crucial for effective asthma management
- Treatment should be individualized based on the severity of symptoms, patient response, and risk factors for asthma-related complications, as outlined in the guidelines 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. (1.1) SINGULAIR is prescribed for the treatment of asthma, the prevention of exercise-induced asthma, and allergic rhinitis: Asthma. SINGULAIR should be used for the long-term management of asthma in adults and children ages 12 months and older.
Asthma treatments include:
- Salmeterol (INH): a long-acting beta2-adrenergic agonist (LABA) used in combination with a corticosteroid for twice-daily treatment of asthma in patients aged 4 years and older 2.
- Montelukast (PO): a leukotriene receptor antagonist used for the long-term management of asthma in adults and children ages 12 months and older 3.
From the Research
Asthma Treatment Options
- Inhaled corticosteroids (ICSs) are a common treatment for asthma, and can be used alone or in combination with other medications 4, 5, 6, 7, 8
- Long-acting beta2-agonists (LABAs) can be used in combination with ICSs to improve asthma control 4, 5
- Leukotriene antagonists, such as montelukast, can be used as an alternative to ICSs, but may not be as effective 4
- Short-acting beta2-agonists (SABAs) can be used as needed for rescue therapy 7, 8
Treatment Guidelines
- The National Asthma Education and Prevention Program recommends a stepwise approach to asthma treatment, with treatment escalating or de-escalating based on symptom control 7
- The Global Initiative for Asthma (GINA) guidelines recommend that all asthma patients be treated with inhaled corticosteroids taken daily or as needed 8
- The 2020 Asthma Guideline Update from the National Asthma Education and Prevention Program provides updated recommendations for treatment of patients with asthma, including the use of intermittent inhaled corticosteroids, add-on long-acting muscarinic antagonists, and fractional exhaled nitric oxide testing 7
Comparison of Treatment Options
- A study comparing fluticasone propionate/salmeterol combination with montelukast found that the combination product was more effective in improving asthma control and patient satisfaction 4
- A study comparing combined salmeterol/fluticasone propionate with fluticasone propionate alone found that the combination product was more effective in improving lung function and asthma symptoms in patients with mild persistent asthma 5