Selecting the Optimal Therapy for Mild Asthma

Murphy et al said that management of mild asthma has undergone a paradigm shift in recent years. Mild intermittent asthma has classically been treated with short-acting bronchodilators (primarily short-acting β2-agonists [SABAs]) for as-needed symptomatic management with addition of a controller medication indicated for patients with persistent symptoms, prior exacerbations, or risk factors for acute exacerbations. However, multiple recent studies have demonstrated that treatment with an inhaled corticosteroid (ICS) for patients with mild asthma is associated with improvement in asthma-related symptoms and reduced exacerbation frequency in comparison with SABA monotherapy. Critically, the analysis was conducted in subgroups based on preenrollment status, including those with uncontrolled disease on as-needed SABA therapy before study enrollment and those with previously well-controlled asthma managed on either daily low-dose ICS or a leukotriene receptor antagonist (LTRA).