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Related Experiment Videos

Chronic Asthma Treatment: Common Questions and Answers.

Tyler J Raymond¹, Thomas A Peterson¹, Jessica Coulter²

¹Uniformed Services University of the Health Sciences, Bethesda, Maryland.

American Family Physician

|April 13, 2023

Summary

Proper asthma management is crucial, as 62% of adults have uncontrolled symptoms. Guideline-directed therapy, including inhaled corticosteroids and single maintenance and reliever therapy, improves asthma control and reduces exacerbations.

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Area of Science:

Pulmonology
Allergology
Clinical Medicine

Background:

Asthma impacts over 25 million Americans, with a significant portion experiencing inadequately controlled symptoms.
Effective asthma management requires regular assessment of severity and control using validated tools like the Asthma Control Test or asthma APGAR.

Purpose of the Study:

To outline current recommendations for asthma assessment and treatment.
To emphasize guideline-directed stepwise therapy for achieving asthma control.

Main Methods:

Review of current asthma guidelines from the National Asthma Education and Prevention Program and Global Initiative for Asthma.
Discussion of pharmacologic treatments including short-acting beta2 agonists, controller medications, and newer agents like biologics.
Consideration of immunotherapy options for allergic asthma.

Main Results:

Short-acting beta2 agonists are preferred for symptom relief.
Inhaled corticosteroids are first-line controllers, with stepwise addition of other medications as needed.
Single maintenance and reliever therapy (SMART) is effective for adults and adolescents in reducing exacerbations.

Conclusions:

Stepwise adjustment of controller and reliever medications based on asthma control is essential.
Subcutaneous immunotherapy is recommended for specific allergic asthma cases, while sublingual is not.
Severe, uncontrolled asthma warrants reassessment and potential specialty referral or consideration of biologic agents.