Advances in Asthma Treatment

There is no cure for asthma, but clinical advances over the past 20 years have created “control” medicines to help reduce inflammation and prevent attacks, and “reliever” medicines to relieve symptoms during attacks.

According to National Asthma Education and Prevention Program (NAEPP) guidelines, these medicines effectively control asthma when used in a stepwise approach. Treatment begins with lower doses for milder asthma and progresses to higher doses and add-on medicines to manage more serious symptoms. 

Inhaled corticosteroids (ICS) are control medicines taken daily to manage persistent asthma. ICS drugs are “first-line” therapy for long-term use. The most recent ICS, Alvesco, was introduced in 2008 and has since been approved for use in children. 

Long-acting beta agonists (LABAs) are reliever drugs that act fast to open constricted airways. LABAs are effective “second-line” treatment when added to ICS drugs. In 2010, the FDA issued new labeling for LABAs, indicating that these drugs should not be used alone but only in combination with controller medicines. Using LABAs alone poses a risk for worsening asthma symptoms over time. 

Newer anti-asthma therapies introduced in the 2000s include combination drugs and treatments for specific types of asthma. In 2010, FDA approved Dulera, a combination ICS and LABA therapy. In 2012, Rayos delayed –release tablets were approved to treat certain inflammatory diseases, including asthma. 

In addition to medications, the NAEPP guidelines point to patient education, monitoring, and controlling environmental triggers as important ways to improve control of asthma. Patient compliance is an ongoing challenge: studies show that only one-third of asthma patients consistently follow recommended treatment. 

References:
Global Initiative for Asthma (GINA) 
National Asthma Education and Prevention Program (2007 Guidelines) 
Cowen and Company, Therapeutic Categories Outlook 2012 

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