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Respiratory Research
Published in: Respiratory Research 1/2004

Open Access 01-12-2004 | Review

Add-on therapy options in asthma not adequately controlled by inhaled corticosteroids: a comprehensive review

Authors: Hannu Kankaanranta, Aarne Lahdensuo, Eeva Moilanen, Peter J Barnes

Published in: Respiratory Research | Issue 1/2004

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Abstract

Many patients with persistent asthma can be controlled with inhaled corticosteroids (ICS). However, a considerable proportion of patients remain symptomatic, despite the use of ICS. We present systematically evidence that supports the different treatment options. A literature search was made of Medline/PubMed to identify randomised and blinded trials. To demonstrate the benefit that can be obtained by increasing the dose of ICS, dose-response studies with at least three different ICS doses were identified. To demonstrate whether more benefit can be obtained by adding long-acting β2-agonist (LABA), leukotriene antagonist (LTRA) or theophylline than by increasing the dose of ICS, studies comparing these options were identified. Thirdly, studies comparing the different "add-on" options were identified. The addition of a LABA is more effective than increasing the dose of ICS in improving asthma control. By increasing the dose of ICS, clinical improvement is likely to be of small magnitude. Addition of a LTRA or theophylline to the treatment regimen appears to be equivalent to doubling the dose of ICS. Addition of a LABA seems to be superior to an LTRA in improving lung function. However, addition of LABA and LTRA may be equal with respect to asthma exacerbations. However, more and longer studies are needed to better clarify the role of LTRAs and theophylline as add-on therapies.
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Metadata
Title
Add-on therapy options in asthma not adequately controlled by inhaled corticosteroids: a comprehensive review
Authors
Hannu Kankaanranta
Aarne Lahdensuo
Eeva Moilanen
Peter J Barnes
Publication date
01-12-2004
Publisher
BioMed Central
Published in
Respiratory Research / Issue 1/2004
Electronic ISSN: 1465-993X
DOI
https://doi.org/10.1186/1465-9921-5-17

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