Asthma Management and Therapeutic Approaches

Asthma is a heterogeneous respiratory disorder characterised by variable airflow obstruction, bronchial hyperresponsiveness and underlying airway inflammation. Management seeks to minimise symptoms, prevent exacerbations and preserve lung function through a control-based, stepwise approach. Conventional pharmacotherapy centres on inhaled corticosteroids to suppress inflammation combined, where necessary, with bronchodilators such as long-acting β2-agonists. In recent years, treatment paradigms have shifted towards personalised regimens informed by phenotypic biomarkers, enabling targeted use of monoclonal antibodies against key inflammatory mediators. Global strategy documents advocate early intervention, regular review of inhaler technique and adherence, and provision of written asthma action plans. Attention has also turned to digital health platforms for remote monitoring and decision support. Emerging therapies under evaluation include novel anti-alarmin and small-molecule inhibitors, while advances in inhaler design aim to improve drug deposition and patient acceptability. Together, these developments underscore a move from one-size-fits-all therapy to precision management, with the dual objectives of optimising individual outcomes and addressing global disparities in asthma care.

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Asthma Management and Therapeutic Approaches publication trend

The graph below shows the total number of articles in asthma management and therapeutic approaches across all publications each year (not limited to Nature Index journals).

Technical terms

Inhaled corticosteroid (ICS): Anti-inflammatory medication delivered via inhaler to reduce airway swelling and hyperresponsiveness.

Short-acting β2-agonist (SABA): Bronchodilator providing rapid relief of bronchoconstriction but lacking sustained anti-inflammatory effect.

Severe exacerbation: An acute or subacute episode of progressive worsening of symptoms requiring systemic corticosteroids, emergency care or hospitalisation.

Maintenance-and-reliever therapy (MART): A regimen in which the same inhaled corticosteroid–formoterol combination is used regularly and as needed for symptom relief.

Biologics: Monoclonal antibodies targeting specific inflammatory pathways (for example, IgE or interleukin-5) in patients with severe or refractory asthma.

References

1. Key recommendations for primary care from the 2022 Global Initiative for Asthma (GINA) update. npj Primary Care Respiratory Medicine (2023).
2. Short-Acting Beta-2-Agonist Exposure and Severe Asthma Exacerbations: SABINA Findings From Europe and North America. The Journal of Allergy and Clinical Immunology In Practice (2022).
3. Treatment strategies for asthma: reshaping the concept of asthma management. Allergy, Asthma & Clinical Immunology (2020).