New approaches to basic treatment of asthma

Abstract

Among chronic respiratory diseases, asthma is one of the most common diseases. The current goal of asthma treatment is to achieve asthmacontrol. Despite the fact that, according to the data of randomized trials, this goal is achievable in most patients, in real clinical practice the proportion of patients who have achieved asthmacontrol does not exceed 42–49%. The article provides an analysis of these recommendations and a literature review of those studies that justify their changes. A key change in the new GINA recommendations is the rejection of shortacting beta2agonists as monotherapy in patients with mild stage I asthma. The priority regimen of basic therapy at this stage of treatment is now a fixed combination of budesonide/formoterol, taken on demand. Such therapy, according to the literature, was significantlymoreeffectivethanshortactingbeta2 agonists monotherapy. In addition, budesonide/ formoterol is also considered as a priority drug for relieving symptoms on demand, and short acting beta2agonists is currently classified as an alternative drug. The recommendation is based on the data of randomized trials, in which it was proved that the use of a fixed combination of budesonide/ formoterol on demand, significantly reduces the number of exacerbations of asthma compared with the use of shortacting beta2agonists on demand. The introduction of new GINA recommendations into practice will improve the effectiveness of basic therapy for asthma.