Anti-inflammatory drugs

Medications that treat the underlying inflammation associated with asthma are known as controller medications and include inhaled corticosteroids (ICSs), leukotriene modifiers, anti-immunoglobulin E (IgE) therapy and oral corticosteroids.

ICSs

ICSs are currently considered to be the most effective anti-inflammatory medications available for the treatment of persistent asthma.¹ They improve quality of life and lung function.² They also reduce the frequency and severity of exacerbations³ as well as airway hyperresponsiveness.⁴

ICS monotherapy is recommended by GINA as the first-line treatment option for most asthma patients. Almost all physicians questioned in the Global Asthma Physician and Patient (GAPP) Survey agreed that ICSs are the “gold standard” treatment for asthma.⁵

For the treatment of asthma, an ideal ICS should:

Be able to enter and treat the small airways
Have high receptor binding
Have high pulmonary deposition
Possess prolonged lung activity
Reduce the need for rescue medication
Improve pulmonary function
Minimize side effects

Find out more about Alvesco^®, an ICS that can be used as monotherapy or together with long-acting β₂-agonists (LABAs).

Despite the benefits of using ICSs to maintain asthma control,¹ a number of side effects can be associated with their long-term use:

See the section on Clinical tolerability for more information about Alvesco^®'s safety and tolerability profile.

Leukotriene modifiers

Leukotriene modifiers block the activity of leukotrienes, which are signalling molecules that promote bronchoconstriction. They may be used as an alternative treatment for patients with mild persistent asthma who are unable or unwilling to use ICSs, or who experience intolerable side effects with ICSs, such as persistent hoarseness. Leukotriene modifiers are not as efficacious as low-dose ICSs.¹

Anti-IgE therapy

This is a treatment option limited to patients with elevated IgE serum levels. They are currently indicated only for patients with severe allergic asthma who are uncontrolled on ICSs.¹

Oral corticosteroids

Oral corticosteroids possess anti-inflammatory and immunosuppressive properties, but their use is reserved for patients with severe uncontrolled asthma due to side effects associated with their use.

References:

From the Global Strategy for Asthma Management and Prevention, Global Initiative for Asthma (GINA) 2011. Available from: http://www.ginasthma.org/
Juniper EF, Kline PA, Vanzieleghem MA, et al. Effect of long-term treatment with an inhaled corticosteroid (budesonide) on airway hyperresponsiveness and clinical asthma in nonsteroid-dependent asthmatics. Am Rev Respir Dis 1990;142:832-6
Pauwels RA, Löfdahl CG, Postma DS, et al. Effect of inhaled formoterol and budesonide on exacerbations of asthma. Formoterol and Corticosteroids Establishing Therapy (FACET) International Study Group. N Engl J Med 1997;337:1405-11
The Childhood Asthma Management Program Research Group. Long-term effects of budesonide or nedocromil in children with asthma. N Engl J Med 2000;343:1054-63
The Global Asthma Physician and Patient Survey, 2005. Available from: http://www.gappsurvey.org/index.html
Zitt M. Properties of the ideal corticosteroid therapie. Allergy Asthma Proc 2005;26:173-182