What is the treatment for asthma?

From the Guidelines

Asthma treatment should involve a combination of quick-relief and long-term control medications, with inhaled corticosteroids as the preferred long-term control medication, as they improve asthma control more effectively than any other single long-term control medication 1. The goal of asthma treatment is to achieve and maintain control of symptoms, prevent exacerbations, and improve quality of life.

• Quick-relief medications, such as short-acting beta-agonists like albuterol, are used to treat acute symptoms and exacerbations.
• Long-term control medications, such as inhaled corticosteroids, are used daily to achieve and maintain control of persistent asthma.
• Combination inhalers containing both a corticosteroid and a long-acting beta-agonist, like fluticasone/salmeterol or budesonide/formoterol, are often prescribed for moderate to severe asthma 1. Some additional options for asthma treatment include:
• Leukotriene modifiers like montelukast, which can be used as an alternative therapy for mild persistent asthma or as adjunctive therapy with inhaled corticosteroids.
• Biologics for severe asthma, which can be used as adjunctive therapy for patients who require step 5 or 6 care.
• Oral corticosteroids for acute exacerbations, which can be used to speed recovery and prevent recurrence of exacerbations. Proper inhaler technique is crucial for medication effectiveness, and patients should also identify and avoid asthma triggers, maintain an asthma action plan, and have regular follow-ups with healthcare providers 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 treatment for asthma includes the use of Wixela Inhub (a combination of fluticasone propionate and salmeterol) for twice-daily treatment in patients aged 4 years and older. The dosage varies by age and asthma severity.

• For patients aged 12 years and older, the dosage is 1 inhalation of Wixela Inhub 100/50, Wixela Inhub 250/50, or Wixela Inhub 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 (SINGULAIR) can be used for the long-term management of asthma in adults and children ages 12 months and older, taken once a day in the evening 3.

From the Research

Treatment Options for Asthma

• Inhaled corticosteroids (ICSs) are considered the most effective anti-inflammatory drugs for asthma 4
• Long-acting beta2-agonists (LABAs) can be used as add-on therapy to ICSs for patients whose asthma is not controlled by ICSs alone 5
• Leukotriene receptor antagonists (LTRAs) can also be used as add-ons to ICS therapy in patients whose asthma is not controlled by ICSs alone 5

Combination Therapies

• The combination of ICSs and LABAs is effective in achieving asthma control, as it treats both components of asthma pathophysiology, namely inflammation and smooth muscle dysfunction of the airways 5
• The salmeterol-fluticasone propionate combination (SFC) produces consistently greater improvements in pulmonary lung function and control of asthma than does the addition of an LTRA to fluticasone propionate 5
• Fixed-dose combinations, such as fluticasone/salmeterol and budesonide/formoterol, are commonly used as maintenance treatment regimens for chronic asthma 6

Comparison of Treatment Options

• Studies have shown that the addition of an LABA to ICS therapy provides greater improvements in pulmonary function and overall control of asthma compared to the addition of an LTRA to ICS therapy 5, 7
• Inhaled corticosteroids have been shown to be more effective than leukotriene receptor antagonists in achieving asthma control 4
• The choice between different combination therapies, such as fluticasone/salmeterol and budesonide/formoterol, should be based on individual patient needs and responses to treatment 6