Asthma therapy aims to achieve and maintain daily control of symptoms of the disease and avoid future risks, thus preventing asthma exacerbations and mortality.
Therapy should follow a stepwise approach: step up with poorly controlled symptoms and step down when control is good.
Intermittent asthma: a SABA bronchodilator taken on an as-needed basis is sufficient
Persistent asthma: start maintenance therapy with an ICS:
. Mild: low dose of ICS
. Moderate: add a LABA and give a low dose of ICS, or a medium dose if control is inadequate
. Severe: increase dose of ICS and if control is inadequate add an oral corticosteroid
Ongoing systematic evaluation of the patient and assessment of response to treatment
Reassess within 2-3 months of treatment initiation and continue with revisions every 3-12 months.
ICS are the most effective drugs for treating asthma (most patients are controlled with low doses).