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Current therapies for asthma. Promise and limitations
1Department of Thoracic Medicine, National Heart and Lung Institute, London, UK.
Chest
|February 1, 1997
Summary
Despite existing asthma treatments, rising morbidity and mortality necessitate new approaches. Future asthma therapy will focus on targeted oral medications with fewer side effects, addressing the disease
Area of Science:
- Pulmonology
- Pharmacology
- Allergy and Immunology
Background:
- Asthma morbidity and mortality rates continue to rise despite the availability of effective treatments.
- Current asthma management relies on bronchodilators (beta 2-agonists, theophylline, anticholinergics) and anti-inflammatory agents (glucocorticoids, cromones).
- Existing therapies have limitations, including side effects, varying efficacy, and the need for frequent administration.
Purpose of the Study:
- To review current asthma treatment modalities and their associated benefits and drawbacks.
- To explore the evolving landscape of asthma pharmacotherapy.
- To highlight the emerging trend towards targeted oral medications for asthma management.
Main Methods:
- Review of existing literature on asthma pharmacotherapy.
- Analysis of current drug classes used for asthma treatment, including inhaled beta 2-agonists, glucocorticoids, theophylline, cromones, and anticholinergic agents.
- Discussion of the therapeutic profiles, efficacy, and side effect profiles of these agents.
Main Results:
- Inhaled beta 2-agonists are effective bronchodilators for acute, severe asthma.
- Inhaled glucocorticoids are the first-line treatment for chronic asthma, reducing airway inflammation.
- Theophylline offers benefits for severe and nocturnal asthma, potentially with immunomodulatory effects, but requires costly monitoring.
- Cromones are suitable for mild asthma with minimal side effects but require frequent dosing.
- Anticholinergic agents are more beneficial for COPD than chronic asthma.
- Theophylline's plasma concentration monitoring is expensive and inconvenient.
Conclusions:
- Current asthma treatments, while effective, have limitations that contribute to ongoing morbidity and mortality.
- There is a clear need for refined and novel therapeutic strategies.
- The future of asthma treatment is shifting towards orally administered medications specifically targeting the pathogenesis of asthma with improved safety profiles.