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Complementary therapy in asthma: inhaled corticosteroids and what?
Curr Opin Pulm Med. 2009 Jan; 15(1):46-51.CO

Abstract

PURPOSE OF REVIEW

For optimal asthma control, complementary strategies are advocated to cover several aspects of the disease. This mini-review highlights different complementary strategies with special focus on the combined use of inhaled corticosteroids (ICSs) and long-acting beta2 agonists and as an alternative, the combination of ICSs and antileukotrienes.

RECENT FINDINGS

New data show that combinations of ICSs/long-acting beta2 agonists or ICSs with antileukotrienes improve disease stability with concomitant control of the underlying airway inflammation. Moreover, there is some evidence that combination therapy may prevent some aspects of airway remodelling. The use of a fixed combination of both a reliever and a controller medication may have certain advantages compared with a fixed dose regime with as-needed separate reliever therapy. Alternatively, in some asthma phenotypes, such as combined allergic rhinitis and asthma syndrome, the combination of ICSs with antileukotrienes offers a complementary anti-inflammatory treatment in combination with controller effects on both airway compartments.

SUMMARY

This review compares different strategies of complementary therapy in asthma with special focus on how to achieve the best clinical control also aimed at controlling the underlying airway inflammation. We have chosen to focus on two major topics: the use of ICSs and long-acting beta2 agonists in two different strategies, that is, a symptom-driven versus a fixed symptom-preventive approach; and the use of ICSs with a long-acting beta2 agonist versus ICSs and a leukotriene receptor antagonist. What regime should be chosen is highly dependent on the individual phenotype and defined treatment goal.

Authors+Show Affiliations

Department of Respiratory Medicine and Allergology, Heart and Lung Division, University Hospital, Lund, Sweden. Leif.bjermer@med.lu.seNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

19077705

Citation

Bjermer, Leif, and Zuzana Diamant. "Complementary Therapy in Asthma: Inhaled Corticosteroids and What?" Current Opinion in Pulmonary Medicine, vol. 15, no. 1, 2009, pp. 46-51.
Bjermer L, Diamant Z. Complementary therapy in asthma: inhaled corticosteroids and what? Curr Opin Pulm Med. 2009;15(1):46-51.
Bjermer, L., & Diamant, Z. (2009). Complementary therapy in asthma: inhaled corticosteroids and what? Current Opinion in Pulmonary Medicine, 15(1), 46-51. https://doi.org/10.1097/MCP.0b013e32831da926
Bjermer L, Diamant Z. Complementary Therapy in Asthma: Inhaled Corticosteroids and What. Curr Opin Pulm Med. 2009;15(1):46-51. PubMed PMID: 19077705.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Complementary therapy in asthma: inhaled corticosteroids and what? AU - Bjermer,Leif, AU - Diamant,Zuzana, PY - 2008/12/17/entrez PY - 2008/12/17/pubmed PY - 2009/2/28/medline SP - 46 EP - 51 JF - Current opinion in pulmonary medicine JO - Curr Opin Pulm Med VL - 15 IS - 1 N2 - PURPOSE OF REVIEW: For optimal asthma control, complementary strategies are advocated to cover several aspects of the disease. This mini-review highlights different complementary strategies with special focus on the combined use of inhaled corticosteroids (ICSs) and long-acting beta2 agonists and as an alternative, the combination of ICSs and antileukotrienes. RECENT FINDINGS: New data show that combinations of ICSs/long-acting beta2 agonists or ICSs with antileukotrienes improve disease stability with concomitant control of the underlying airway inflammation. Moreover, there is some evidence that combination therapy may prevent some aspects of airway remodelling. The use of a fixed combination of both a reliever and a controller medication may have certain advantages compared with a fixed dose regime with as-needed separate reliever therapy. Alternatively, in some asthma phenotypes, such as combined allergic rhinitis and asthma syndrome, the combination of ICSs with antileukotrienes offers a complementary anti-inflammatory treatment in combination with controller effects on both airway compartments. SUMMARY: This review compares different strategies of complementary therapy in asthma with special focus on how to achieve the best clinical control also aimed at controlling the underlying airway inflammation. We have chosen to focus on two major topics: the use of ICSs and long-acting beta2 agonists in two different strategies, that is, a symptom-driven versus a fixed symptom-preventive approach; and the use of ICSs with a long-acting beta2 agonist versus ICSs and a leukotriene receptor antagonist. What regime should be chosen is highly dependent on the individual phenotype and defined treatment goal. SN - 1531-6971 UR - https://www.unboundmedicine.com/medline/citation/19077705/Complementary_therapy_in_asthma:_inhaled_corticosteroids_and_what L2 - https://doi.org/10.1097/MCP.0b013e32831da926 DB - PRIME DP - Unbound Medicine ER -