The Treatment of Mild and Moderate Asthma in Adults

Marek Lommatzsch, Roland Buhl, Stephanie Korn
Deutsches Ärzteblatt International 2020 June 19, 117 (25): 434-444

BACKGROUND: Asthma is a chronic inflammatory airway disease that usually causes variable airway obstruction. It affects 5-10% of the German population.

METHODS: This review is based on relevant publications retrieved by a selective search, as well as on national and international guidelines on the treatment of mild and moderate asthma in adults.

RESULTS: The goal of treatment is to attain optimal asthma control with a minimal risk of exacerbations and mortality, loss of pulmonary function, and drug side effects. This can be achieved with a combination of pharmacotherapy and non-drug treatment including patient education, exercise, smoking cessation, and rehabilitation. Pharmacohterapy is based on inhaled corticosteroids (ICS) and bronchodilators. It is recommended that mild asthma should be treated only when needed, either with a fixed combination of ICS and formoterol or with short-acting bronchodilators. For moderate asthma, maintenance treatment is recommended, with an inhaled fixed combinations of ICS and long-acting beta-mimetics, possibly supplemented with longacting anticholinergic agents. Allergen immunotherapy, i.e., desensitization treatment, should be considered if the allergic component of asthma is well documented and the patient is not suffering from uncontrolled asthma. Asthma control should be monitored at regular intervals, and the treatment should be adapted accordingly.

CONCLUSION: The treatment of asthma in adults should be individually tailored, with anti-inflammatory treatment as its main component.

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