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Intermittent and mild persistent asthma: how therapy has changed.

Maria Elisa Di Cicco1, Maddalena Leone2, Maria Scavone3

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Mild asthma management is evolving, shifting from solely relying on short-acting beta 2 agonists to incorporating inhaled corticosteroids. This update addresses inflammation and optimizes inhaler use for better treatment outcomes in children.

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Area of Science:

  • Pediatric Pulmonology
  • Allergy and Immunology
  • Pharmacology

Background:

  • Mild asthma is more prevalent than severe asthma in children, contributing significantly to emergency visits.
  • Current management strategies for intermittent and mild persistent asthma are under review.
  • Over-reliance on short-acting beta 2 agonists as a sole rescue medication poses risks.

Purpose of the Study:

  • To review the evolving management strategies for intermittent and mild persistent asthma in children.
  • To highlight the importance of understanding drug-device characteristics for optimal inhaler therapy.
  • To emphasize the role of adherence and digital health in pediatric asthma care.

Main Methods:

  • Literature review of recent studies and international guidelines (e.g., GINA).
  • Analysis of the role of inflammation in mild asthma phenotypes.
  • Discussion of inhaled corticosteroid use and short-acting beta 2 agonist overuse.

Main Results:

  • Emerging evidence supports the role of inflammation in mild asthma, necessitating updated treatment approaches.
  • International guidelines are beginning to recommend combining corticosteroids with reliever inhalers.
  • Optimizing drug delivery and patient adherence are crucial for effective asthma control.

Conclusions:

  • The management of mild asthma is transitioning towards incorporating inhaled corticosteroids, even for intermittent use.
  • Proper understanding of inhaler devices and patient compliance, enhanced by digital tools, are key to improving treatment efficacy.
  • Addressing inflammation and reducing reliever overuse are critical for better asthma outcomes in children.