Current Allergy and Asthma Reports

, Volume 13, Issue 5, pp 427–433

Symptom-Based Controller Therapy: A New Paradigm for Asthma Management

  • Rohit Divekar
  • Bill T. Ameredes
  • William J. Calhoun
ASTHMA (WJ CALHOUN AND SP PETERS, SECTION EDITORS)

DOI: 10.1007/s11882-013-0375-7

Cite this article as:
Divekar, R., Ameredes, B.T. & Calhoun, W.J. Curr Allergy Asthma Rep (2013) 13: 427. doi:10.1007/s11882-013-0375-7

Abstract

Appropriate management of persistent asthma, according to US and international guidelines, requires daily use of controller medications, most generally, inhaled corticosteroids (ICS). This approach, although effective and well established, imposes burdens of treatment and side effects onto asthma patients. A growing body of evidence suggests that patients with persistent asthma need not be managed with daily ICS, but rather can use them on an intermittent basis, occasioned by the occurrence of symptoms sufficient to warrant treatment with a rescue inhaler. Large, randomized, controlled studies, over a range of asthma severity, and in a range of ages from pediatrics to adults, suggest that, in well-selected patients, a symptom-based approach to administering controller therapy may produce equivalent outcomes, while reducing exposure to ICS. The concept of providing anti-inflammatory treatment to the patient, at the time inflammation is developing, is termed ‘temporal personalization’. The evidence to date suggests that symptom-based controller therapy is broadly useful in selected asthma patients, and is a management approach that could be incorporated into US and international guidelines for asthma.

Keywords

Asthma Inhaled corticosteroids Symptom-based controller therapy Management Treatment 

Abbreviations

ACRN

US Asthma Clinical Research Network

BASALT

Best Adjustment Strategy for Asthma in the Long Term

BEST

Beclomethasone plus Salbutamol Treatment

ICS

Inhaled corticosteroids

IMPACT

Improving Asthma Control

MIST

Maintenance vs. Intermittent inhaled Steroids in wheezing Toddlers

NHLBI

US National Heart Lung and Blood Institute

NO

Nitric oxide

TREXA

Treating children to prevent Exacerbations

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Rohit Divekar
    • 1
    • 3
  • Bill T. Ameredes
    • 2
    • 3
  • William J. Calhoun
    • 1
    • 2
    • 3
  1. 1.Division of Allergy and Clinical ImmunologyUniversity of Texas Medical BranchGalvestonUSA
  2. 2.Division of Pulmonary, Critical Care, and SleepUniversity of Texas Medical BranchGalvestonUSA
  3. 3.Institute for Translational SciencesUniversity of Texas Medical BranchGalvestonUSA

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