Asthma management

The main goal of asthma therapy is to achieve control of respiratory symptoms through patient education, environmental control and drug therapy. According to the GINA guidelines, asthma control can be achieved using appropriate pharmacotherapy and by appropriate adjustment of treatment¹ (Figure 1).

Physicians should routinely re-assess the degree of asthma control and, if necessary, adjust their treatment strategies (Figure 1). When asthma is under control, medication can be reduced to find the lowest level that maintains good or acceptable control. As recommended by GINA, pharmacological therapy is the cornerstone of asthma management. All asthma drugs should be used at the lowest possible dose and frequency to maintain acceptable control of asthma symptoms.

In treatment-naïve patients with persistent asthma, treatment should be started at step 2, or, if very symptomatic (uncontrolled), at step 3 (Figure 1).¹

Despite the inflammation and remodelling observed in the small airways of asthmatic patients,² current guidelines do not take into account the need to treat this region of the lungs.

For more information on the different therapeutic options available to asthma patients, please see Therapeutic options .

Figure 1: Asthma management approach based on control¹

References:

For the Global Strategy for Asthma Management and Prevention, updated 2011 used with permission from the Global Initiative for Asthma (GINA): http://www.ginasthma.org/
Contoli M, Bousquet J, Fabbri LM, et al. The small airways and distal lung compartment in asthma and COPD: a time for reappraisal. Allergy 2010;65:141-151