Achieving asthma control in patients with moderate disease

作者：FitzGerald J Mark^*; Shahidi Neal

来源：Journal of Allergy and Clinical Immunology, 2010, 125(2): 307-311.

DOI：10.1016/j.jaci.2009.12.978

• Asthma control
• moderate disease
• education
• inhaled corticosteroids
• long acting beta agonists

Patients with moderate asthma are symptomatic on an ongoing basis. They are usually treated initially with low-dose inhaled corticosteroids (ICSs) supplemented with a short-acting bronchodilator as a rescue medication. Most steroid-naive patients will achieve good control with this strategy. For patients in whom adherence, inhaler technique, environmental control, and comorbidities have been addressed but who still have uncontrolled symptoms, the addition of a long-acting beta-adrenergic agonist should be considered. Some patients might require a higher close of ICS. Leukotriene receptor antagonists might be considered as alternate initial therapy or as an add-on to maintenance therapy with an ICS. All patients should receive a structured education program emphasizing the need for ongoing maintenance treatment, even when control is achieved. Patients should also be provided with a written action plan that clearly explains which additional anti-inflammatory therapy should be taken if asthma symptoms worsen. The most effective strategy in this situation has been shown to be the quadrupling of the maintenance dose of ICS. (J Allergy Clin Immunol 2010;125:307-11.)

• 出版日期2010-2