Problem of mild bronchial asthma revisited

Abstract

It is estimated that 50-75% of bronchial asthma cases have mild (intermittent or persistent) severity of asthma. Despite the minimal number of daily symptoms, endobronchial inflammation and a high risk of exacerbations have been demonstrated in a significant proportion of patients. According to the current guidelines, anti-inflammatory drugs - inhaled glucocorticosteroids - maintenance therapy is only added at stage 1, which is characterized by an insufficient level of control and repeated exacerbations due to the use of short-acting в-agonists to be taken as required. Inhaled glucocorticosteroids in low doses become the drugs of choice at stage 2 for patients with mild persistent bronchial asthma. As-needed use of inhaled glucocorticosteroids combined with в-agonists, which has a rapid onset of action (salbutamol or formoterol) may become an alternative to the daily used of drugs. The choice of such type of management should be justified by the low risk of exacerbation (based on an assessment of risk factors for adverse clinical out-comes/exacerbations of bronchial asthma). The as-needed use of such combination can provide a high patient commitment to medical recommendations, create a sufficient anti-inflammatory effect, reduce the likelihood of exacerbations and reduce the risk of adverse effects.

Keywords

• mild asthma
• as-need inhaled glucocorticosteroids
• beclomethasone/salbutamol