An overview of the current status of the drug therapy of asthma.

Abstract

The importance of inflammation as the central lesion in asthma is being increasingly recognised and it is proposed that the emphasis of therapy should be altered from simply treating symptoms, to trying to control inflammation at an early stage of the disease. A "tight control" treatment program to achieve this is outlined. Treatment regimes for asthma may therefore need to be re-assessed, although the most commonly used drugs (beta 2-adrenoceptor agonists, theophylline, corticosteroids and cromoglycate) are effective if used properly. For the majority of patients management is grossly inadequate in terms of diagnosis, assessment of disease severity and treatment. The death rate from asthma still remains unacceptably high and some strategies are outlined for the identification of patients at risk and the improvement of their management. This overview considers four central issues: (1) the lesions that should be the target for drug treatment; (2) an outline of the available drug treatment; (3) the aims of treatment and (4) the success of drug treatment in terms of morbidity and mortality.