Pharmacological Management of Asthma
Summary
A robust pharmacological toolkit has been established to manage asthma across its variable phenotypes and severities. Long-term control utilises inhaled corticosteroids (ICS) to suppress airway inflammation, often combined with long-acting β2-agonists (LABAs) to maintain bronchodilation. Short-acting β2-agonists (SABAs) remain essential for as-needed relief of bronchoconstriction. Add-on therapies include leukotriene receptor antagonists (LTRAs) and long-acting muscarinic antagonists (LAMAs), which target complementary inflammatory and bronchomotor pathways. In severe or refractory disease, systemic corticosteroids and targeted biologic agents against immunoglobulin E or interleukins modulate Type 2 inflammation and reduce exacerbations. Recent advances emphasise personalised medicine: phenotyping by biomarkers guides therapeutic selection, while novel combination inhalers and extrafine formulations enhance lung deposition and adherence. The global burden of asthma demands accessible, cost-effective regimens and strategic escalation pathways that balance efficacy, safety and patient preference to optimise long-term control and quality of life.
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Pharmacological Management of Asthma publication trend
The graph below shows the total number of articles in pharmacological management of asthma across all publications each year (not limited to Nature Index journals).
Technical terms
Inhaled corticosteroid (ICS): Anti-inflammatory medication delivered by inhalation to reduce airway inflammation.
Long-acting β2-agonist (LABA): Bronchodilator providing prolonged airway smooth muscle relaxation.
Leukotriene receptor antagonist (LTRA): Oral agent blocking leukotriene-mediated bronchoconstriction and inflammation.
Long-acting muscarinic antagonist (LAMA): Bronchodilator inhibiting muscarinic receptors to prevent airway constriction.
Biologic agent: Monoclonal antibody targeting specific immune pathways in severe asthma.
References
- A comparison of tiotropium, long-acting β2-agonists and leukotriene receptor antagonists on lung function and exacerbations in paediatric patients with asthma. Respiratory Research (2020).
- Inhaled Formoterol‐Fluticasone Single Inhaler Therapy in Asthma: Real‐World Efficacy, Budget Impact, and Potential to Improve Adherence. Canadian Respiratory Journal (2020).
- High strength extrafine pMDI beclometasone/formoterol (200/6 μg) is effective in asthma patients not adequately controlled on medium-high dose of inhaled corticosteroids. BMC Pulmonary Medicine (2016).
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