Add-on Therapy for Symptomatic Asthma despite Long-Acting Beta-Agonists/Inhaled Corticosteroid

Tuberc Respir Dis. 2017;80:e18. English.
Published online Dec 13, 2017.  https://doi.org/10.4046/trd.2017.0102 

Michael Dreher, M.D. and Tobias Müller, M.D

 

Abstract

Asthma, remains symptomatic despite ongoing treatment with high doses of inhaled corticosteroids (ICS) in conjunction with long-acting beta-agonists (LABA), is classified as “severe” asthma. In the course of caring for those patients diagnosed with severe asthma, stepping up from ICS/LABA to more aggressive therapeutic measures would be justified, though several aspects have to be checked in advance (including inhaler technique, adherence to therapy, and possible associated comorbidities). That accomplished, it would be advisable to step up care in accordance with the Global Initiative for Asthma (GINA) recommendations. Possible strategies include the addition of a leukotriene receptor antagonist or tiotropium (to the treatment regimen). The latter has been shown to be effective in the management of several subgroups of asthma. Oral corticosteroids have commonly been used for the treatment of patients with severe asthma in the past; however, the use of oral corticosteroids is commonly associated with corticosteroid-related adverse events and comorbidities. Therefore, according to GINA 2017 these patients should be referred to experts who specialize in the treatment of severe asthma to check further therapeutic options including biologics before starting treatment with oral corticosteroids.

Formats:

(You must be logged in to add and reply comments)

Interasma on Twitter

Interasma Top story: Allergy, Asthma and Immunology: Earlier smoking after waking and the… https://t.co/4D1fp6c8wl, see more https://t.co/CpGiFuOOYd
12hreplyretweetfavorite
Interasma RT @worldallergy: Top story: Juan C Ivancevich MD on Twitter: "“Mount Sinai researchers have iden… https://t.co/F6trY5HZUu, see more https:…
16hreplyretweetfavorite
Interasma RT @Aller_MD: “Weekly Clinical Case Challenge from Derm101” https://t.co/pF9S73bifi https://t.co/RIhysTcqLT
16hreplyretweetfavorite
Interasma RT @Aller_MD: Earlier smoking after waking and the risk of asthma: a cross-sectional study using NHANES data https://t.co/TcZ0vH1zf9
16hreplyretweetfavorite
Interasma RT @Aller_MD: The latest Allergy, Asthma & Immunology! https://t.co/iA6gjSf7NY Thanks to @DrAnneEllis @susanprescott88 #tb #vaccine
16hreplyretweetfavorite

Editor: Juan C. Ivancevich, MD

Copyright © Interasma 2003-2017  •  Terms of Use  •  Privacy Policy  •  Contact Us  •  Sitemap

Powered by FREI SA

InterAsma