Chronic persistent asthma: A review of medicines in the step-up approach

Abstract

AbstractThe medications used in asthma have been the subject of intense study over the last three decades. We now have extensive insights into their structure, regulation, receptors and mechanisms of action. Their intersection with the complexity of asthma inflammation has also been well characterised. In parallel, good quality pharmaceutical trials have informed national guidelines and patient-centered outcomes have been explored. With this therapeutic armamentarium the practitioner should aim to achieve the goals of asthma therapy that are focused on clinical and lung function parameters. The concept of complete asthma control is the current benchmark.Airway inflammation is the fundamental problem in asthma and, logically, anti-inflammatory therapy in the form of inhaled corticosteroids is the single most important intervention. The importance of appropriate use of inhaler devices cannot be sufficiently emphasised. The clinician carefully titrates this treatment utilising additional medications for syne...