[Asthma and obstructive bronchopneumopathies: the consensus]

The prevalence of asthma is at least 5% of the population and that of chronic obstructive pulmonary disease (COPD) is around 20% of the regular smokers. Long term inhaled corticosteroids are the first therapeutical choice for chronic asthma, completed by on demand inhalation of a betamimetic; if an adequate control of the disease is not obtained with a daily dose up to 1 mg, a long acting bronchodilator is also given (oral theophylline and/or salmeterol by inhalation). The drug therapy must be coupled with an in-depth education of the patient and his/her family. Oral corticosteroid use should be limited to the most severe cases. Smoking cessation remains the most efficient treatment for COPD, but also the most difficult enterprise! Bronchodilators, inhaled vagolytics and/or betamimetics. Oral theophyllines are given to patients who complain of dyspnea. Corticosteroids, preferably given by inhalation, can be tried in the most disabled patients; the results of ongoing long term trials will be known in September 1997. When a chronic severe hypoxaemia (PaO2 < 56 mm Hg) develops, long term continuous oxygen therapy is indicated. The efficacy of well conducted rehabilitation programmes is now definitely established.