[Treatment of moderate persistent asthma: inhalation corticosteroids in combination with long acting beta 2-adrenergic agonists (bronchodilators) then with leukotriene receptor antagonists (anti-inflammatory agents); the 'step-3-dilemma']

Abstract

Apart from avoiding airway-irritating agents, the most important issue in the treatment of asthma is the suppression of airway inflammation by pharmaceutical treatment. Inhaled corticosteroids are the cornerstone of the medical treatment of asthma. Recent guidelines recommend the lowest possible effective dose for asthma management. In treatment steps 2 and 3, additive therapy of low to moderately high doses of inhalation corticosteroids in combination with add-on therapy with long-acting beta 2-adrenergic agonists (LABA) and leukotriene receptor antagonists (LTRA) has proved to be effective. LABA are inhaled agents with potent bronchodilator properties, whereas LTRA are taken orally and possess mainly systemic anti-inflammatory properties.