Trials That Matter: Minimizing Treatment of Mild, Persistent Asthma
Authors: Michael A. Grippi
Journal: Annals of Internal Medicine (2007)

Editorials4 September 2007Trials That Matter: Minimizing Treatment of Mild, Persistent AsthmaMichael A. Grippi, MD and Cynthia Mulrow, MD, MSc, Deputy EditorMichael A. Grippi, MDFrom the Hospital of the University of Pennsylvania and Philadelphia Veterans Affairs Medical Center, Philadelphia, PA 19004, and American College of Physicians, Philadelphia, PA 19106.Search for more papers by this author and Cynthia Mulrow, MD, MSc, Deputy EditorFrom the Hospital of the University of Pennsylvania and Philadelphia Veterans Affairs Medical Center, Philadelphia, PA 19004, and American College of Physicians, Philadelphia, PA 19106.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-147-5-200709040-00011 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Current guidelines for management of mild, persistent asthma recommend inhaled corticosteroids as first-line therapy (1–3). Long-term use of these agents in high doses may cause various adverse effects. Therefore, patients may inquire about, and clinicians should consider, alternative management strategies, including low-dose, once-daily inhaled corticosteroids and oral regimens that do not use corticosteroids. Two recently published trials address such approaches (4, 5).What Did These Important Trials Show?The LOCCS (Leukotriene or Corticosteroid or Corticosteroid-Salmeterol) trial involved 500 patients with stable, mild, persistent asthma from 19 centers (4). After receiving open-label inhaled fluticasone propionate (100 µg per puff twice daily) ...References1. Global Initiative for Asthma. Global strategy for asthma management and prevention. Bethesda, MD: National Institutes of Health; 1995. NIH publication no. 95-3659. Google Scholar2. National Asthma Education and Prevention Program. Guidelines for the diagnosis and management of asthma: Expert Panel report 2. Bethesda, MD: National Institutes of Health; 1997. NIH publication no. 97-4051. Google Scholar3. National Asthma Education and Prevention Program. Executive summary of the NAEPP expert panel report: guidelines for the diagnosis and management of asthma—update on selected topics 2002. Bethesda, MD: National Institutes of Health; 2002. NIH publication no. 02-5075. Google Scholar4. American Lung Association Asthma Clinical Research Centers. Randomized comparison of strategies for reducing treatment in mild persistent asthma. N Engl J Med. 2007;356:2027-39. [PMID: 17507702] CrossrefMedlineGoogle Scholar5. Papi A, Canonica GW, Maestrilli P, Olivieri D, Pozzzi E, Crimi N, et al; BEST Study Group. Rescue use of beclomethasone and albuterol in a single inhaler for mild asthma. N Engl J Med. 2007;356:2040-52. [PMID: 17507703] CrossrefMedlineGoogle Scholar6. Salpeter SR, Buckley NS, Ormiston TM, Salpeter EE. Meta-analysis: effect of long-acting beta-agonists on severe asthma exacerbations and asthma-related deaths. Ann Intern Med. 2006;144:904-12. [PMID: 16754916] LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From the Hospital of the University of Pennsylvania and Philadelphia Veterans Affairs Medical Center, Philadelphia, PA 19004, and American College of Physicians, Philadelphia, PA 19106.Disclosures: Honoraria: M.A. Grippi (InterMune Corporation).Corresponding Author: Customer Service, American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106-1572.Current Author Addresses: Dr. Grippi: Philadelphia Veterans Affairs Medical Center, 3900 Woodland Avenue, Philadelphia, PA 19104.Dr. Mulrow: American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106-1572. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByThe American Lung Association: Asthma Clinical Research Centers network: addressing real life questions in asthma management 4 September 2007Volume 147, Issue 5Page: 344-345KeywordsAdverse eventsAsthmaCorticosteroid therapyLeukotrienePropionatesSafetySafety studiesSputumUpper respiratory tract infections ePublished: 4 September 2007 Issue Published: 4 September 2007 CopyrightCopyright © 2007 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...