Choice of basic therapy for asthma in real clinical practice

Cite item

Full Text


According to the Global Initiative for Asthma, the treatment of asthma should be mainly based on its control that encompasses symptom control and exacerbation risk reduction. Control-based treatment contributes to decreases in the frequency of exacerbations, the incidence of drug side effects, the needs of asthmatic patients for emergency care, and the number of their visits to a doctor and hospitalizations, resulting in a reduction of direct health care costs of asthma. Drugs for the basic therapy of asthma are chosen on the basis of evidence for their efficacy and safety and the view of availability and cost of treatment. In case of poor asthma control it is important to reveal its causes and to change basic therapy according to the individual needs of the patient. A major role in the achievement of asthma control is assigned to a combination of inhaled glucocorticosteroids (ICS) and long-acting β2-agonists. Combined medications are prescribed to asthma patients in accordance with the daily ICS dose required to achieve asthma control.

About the authors

I V Leshchenko

I I Baranova


  1. Global strategy for asthma management and prevention, Online appendix, revised 2014. In: Global Initiative for Asthma. URL Available at:
  2. Price D. Asthma control and management in 8,000 European patients: the Rеcognise Asthma and LInk to Symptoms and Experience (REALISE) survey. Prim Care Respir Med 2014; 24: 140—149.
  3. McCoy K., Shade D.M., Irvin C.G. et al. Predicting episodes of poor asthma control in treated patients with asthma. J Allergy Clin Immunol 2006; 118: 1226—1233.
  4. Thomas M., Kay S., Pike J. et al. The asthma control test (ACT) as a predictor of GINA guideline-defined asthma control analysis of a multinational cross-sectional survey. Prim Care Respir J 2009; 18: 41—49.
  5. O’Byrne P.M., Reddel H.K., Eriksson G. et al. Measuring asthma control: a comparison of three classification systems. Eur Respir J 2010; 36: 269—276.
  6. Guhan A.R. Systemic effects of formoterol and salmeterol: a dose-response comparison in healthy subjects. Thorax 2000; 55: 650—656.
  7. Matsumoto H. Effects of inhaled corticosteroid and short courses of oral corticosteroids on bone mineral density in asthmatic patients: a 4-year longitudinal study. Chest 2001; 120 (5): 1468—1473.
  8. Turner M.O., Noertjojo K., Vedal S. et al. Risk factors for near-fatal asthma. A case-control study in hospitalized patients with asthma. Am J Respir Crit Care Med 1998; 157: 1804—1809.
  9. Miller M.K., Lee J.H., Miller D.P., Wenzel S.E. Resent asthma exacerbations: a key predictor of future exacerbations. Respir Med 2007; 101: 481—489.
  10. Haselkorn T., Fish J.E., Zeiger R.S., et al. Consistently very poorly control asthma, as defined by the impairment domain of the Expert Panel Report 3 guidelines, increases risk for future severe asthma exacerbations in the Epidemiology and Natural History of asthma: Outcomes and Treatment Regimens (TENOR) study. J Allergy Clin Immunol 2009; 124: 895—902.
  11. Sussia S., Ernst P., Boivin J.F. et al. A cohort analysis of excess mortality in asthma and the use of inhaled beta-agonists. Am J Respir Crit Care Med 1994; 149: 604—610.
  12. Ernst P., Spitzer W.O., Suissa S. et al. Risk of fatal and near-fatal asthma in relation of inhaled corticosteroid use. JAMA 1992; 268: 3462—3464.
  13. Melani A.S., Bonavia M., Cilenti V. et al. Inhaler mishandling remains common in real life and is associated with reduced disease control. Respir Med 2011; 105: 930—938.
  14. Osborn M.L., Pedula K.L., O’Hollaren M. et al. Assessing future need for acute care in adult asthmatics: The Profile of Asthma Risk Study: a prospective health maintenance organization — based study. Chest 2007; 132: 1151—1161.
  15. Belda J., Giner J., Casan P., Sanchis J. Mild exacerbation and eosinophilic inflammation in patients with stable, well-controlled asthma after 1 year of follow-up. Chest 2001; 119: 1011—1017.
  16. Murphy V.E., Clifton V.L., Gibson P.G. Asthma exacerbations during pregnancy: incidence and association with adverse pregnancy outcomes. Thorax 2006; 61: 169—176.
  17. Melani A.S., Bonavia M., Cilenti V. et al. Inhaler mishandling remains common in real life and is associated with reduced disease control. Respir Med 2011; 105: 930—938.
  18. Chang K.F. New treatments for severe treatment-resistant asthma: targeting the right patient. Lancet Respir Med 2013; 1: 639—652.
  19. Белевский А.С., Цветкова О.А. Форадил Комби: эффективность, безопасность и комплаенс у пациентов с БА. Результаты всероссийской программы «ФРИСТАЙЛ-2». Атмосфера. Пульмонология и аллергология 2013; 3: 29—34.
  20. Reddel H.K., Taylor D.R., Bateman E.D. et al. An official American Thoracic Society/European Respiratory Society clinical practice. Am J Respir Crit Care Med 2009; 180: 59—99.
  21. Taylor D.R., Bateman E.D., Boulet L.P. et al. A new perspectives on concepts of asthma severity and control. Eur Respir J 2008; 32: 545—554.
  22. Chung K.F., Wenzel S.E., Brozek J.L. et al. International ERS/ATS Guidelines on Definition, Evaluation and Treatment of severe asthma. Eur Respir J 2014; 43: 343—373.
  23. Kerstijens H.A., Brand P.L., de Jong P.M., Koeter G.H., Postma D.S. Influence of treatment on pick respiratory flow and its relation to airway hyperresponsiveness and symptoms. The Dutch CNSLD Group. Thorax 1994; 49:1109—1115.
  24. Jekins C.R., Thien F.C., Wheatley J.R., Reddel H.K. Traditional and patient-centred outcomes with three classes of asthma medication. Eur Respir J 2005; 26: 36—44.
  25. Федеральные клинические рекомендации по диагностике и лечению бронхиальной астмы 2013. Доступно на:

Copyright (c) 2015 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Address of the Editorial Office:

  • Novij Zykovskij proezd, 3, 40, Moscow, 125167

Correspondence address:

  • Alabyan Street, 13/1, Moscow, 127055, Russian Federation

Managing Editor:

  • Tel.: +7 (926) 905-41-26
  • E-mail:


© 2018-2021 "Consilium Medicum" Publishing house

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies