Facing the challenge of unmet needs in asthma

Background: As the prevalence of asthma rises, new treatment options are becoming available; however, despite these advances, asthma management continues to be suboptimal in many patients. Objectives: To examine asthma control levels, as evaluated by the occurrence of asthma exacerbations (worsening symptoms, rescue medication use, and emergency department visits or hospitalizations), attained using current treatment methods and to assess the effectiveness of treatment with inhaled corticosteroids (ICSs) alone or combined with long-acting beta(2)-agonists (LABAs). Methods: Selected studies evaluating the effects of using ICSs alone or combined with LABAs on asthma control were reviewed. Results: Most patients with asthma experienced I or more exacerbations per year. Findings from the reviewed studies indicate that aiming for total asthma control by increasing the dose of the administered ICS and adding a LABA to a higher dose of an ICS can reduce the proportion of patients experiencing exacerbations to 5%. These findings suggest that prolonged use of high-dose ICSs may offer beneficial results regarding long-term treatment outcomes. However, with increased use at higher doses, the systemic and oropharyngeal safety of ICSs needs to be carefully considered. Conclusions: Therapy with ICSs alone or combined with LABAs is effective for the treatment of asthma; however, current prescribing patterns may not optimize the potential of these therapies. A reexamination of treatment regimens and goals for asthma therapy is necessary to improve outcomes for patients.