Asthma: current strategies for treatment
Theodore F. Reiss, MD
Muzaffar Ahmad, MDAddress reprint requests to M.A., Chairman, Department of Pulmonary Disease, The Cleveland Clinic Foundation, One Clinic Center, 9500 Euclid Avenue, Cleveland, Ohio 44195.
Mortality from asthma is increasing, raising questions about the goals and adequacy of treatment. It is important to understand the pathophysiology of asthma and the rationale and options for treatment. Asthma, a reversible syndrome of airflow obstruction, is not simply spasm of airway smooth muscle; rather, it is a disease characterized by mucosal edema, mucous hypersecretion, and epithelial damage in the airway. Appropriate medical therapy includes treatment with compounds that specifically suppress airway inflammation. The best approach to treatment may be an anti-inflammatory agent—preferably by inhalation—along with an inhaled direct bronchodilator, with objective measures of airflow limitation to assess disease severity.