Update in the Management and Treatment of Adult Asthma for Primary Care Physicians

Abstract

Asthma is a common illness; estimates are that it affects up to 18% of the global population, with rates increasing every year. Approximately 3.8 million Canadians have asthma, and these patients continue to suffer from inadequately controlled disease as well as exacerbations. Although we have more medication choice than ever, mortality rates in Canada have not declined. Our current pharmacologic strategy has been mostly unchanged for years; it starts with an anti-inflammatory medication, usually an inhaled corticosteroid (ICS) to treat the type 2 (T2) inflammation that is most common. When an ICS provides inadequate control, therapy is often stepped up to include an ICS/long-acting beta-agonist (LABA) combination and even additional therapies like leukotriene receptor antagonists or long-acting muscarinic agents (LAMAs). As patients with uncontrolled asthma are at risk for deleterious outcomes, controlling the disease and preventing exacerbations should be the goal for all patients.