PMID- 12776440
OWN - NLM
STAT- MEDLINE
DCOM- 20030916
LR  - 20161020
IS  - 1088-5412 (Print)
IS  - 1088-5412 (Linking)
VI  - 24
IP  - 2
DP  - 2003 Mar-Apr
TI  - Defining the effects of an inhaled corticosteroid and long-acting beta-agonist on 
      therapeutic targets.
PG  - 85-9
AB  - The effects of inhaled corticosteroids (ICSs) and long-acting beta 2-agonists 
      (LABAs) on therapeutic targets have significant clinical relevance regarding 
      optimal management of asthma. Asthma pathophysiology involves two main 
      components: smooth muscle dysfunction and airway inflammation. LABAs and ICSs 
      provide complementary modes of action in that these agents modulate smooth muscle 
      dysfunction/bronchoconstriction and airway inflammation, respectively. Despite 
      the documented benefits of ICSs, they remain underutilized because of a variety 
      of physician- and patient-associated reasons including safety concerns. 
      Underlying these concerns are published reports that suggest systemic effects of 
      high doses of ICSs: skin bruising, reduction of bone mineral density, cataracts, 
      glaucoma, and impaired short-term growth in children. Simple strategies to reduce 
      the potential adverse effects of inhaled steroids include using the lowest 
      effective maintenance dose and optimizing steroid-sparing strategies, 
      specifically combination therapy with a LABA, leukotriene modifier, or 
      theophylline. LABA therapy, when added to ICS therapy, provides clinically 
      significant steroid-sparing effects while at the same time reducing the rate at 
      which asthma exacerbations occur. Available clinical evidence suggests that the 
      combination of ICS plus LABA is the best available option for the management of 
      moderate persistent asthma. Consequently, this combination is the preferred 
      choice for treating moderate persistent asthma based on current National Asthma 
      Education and Prevention Program guidelines for the diagnosis and treatment of 
      asthma.
FAU - Settipane, Russell A
AU  - Settipane RA
AD  - Brown Medical School, 95 Pitman Street, Providence, RI 02906, USA.
CN  - National Asthma Education and Prevention Program (NAEPP)
LA  - eng
PT  - Guideline
PT  - Journal Article
PT  - Practice Guideline
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PL  - United States
TA  - Allergy Asthma Proc
JT  - Allergy and asthma proceedings
JID - 9603640
RN  - 0 (Adrenal Cortex Hormones)
RN  - 0 (Adrenergic beta-Agonists)
SB  - IM
MH  - Administration, Inhalation
MH  - Adrenal Cortex Hormones/standards/*therapeutic use
MH  - Adrenergic beta-Agonists/standards/*therapeutic use
MH  - Asthma/drug therapy/physiopathology
MH  - Humans
MH  - Severity of Illness Index
MH  - Treatment Outcome
RF  - 32
EDAT- 2003/06/05 05:00
MHDA- 2003/09/17 05:00
CRDT- 2003/06/05 05:00
PHST- 2003/06/05 05:00 [pubmed]
PHST- 2003/09/17 05:00 [medline]
PHST- 2003/06/05 05:00 [entrez]
PST - ppublish
SO  - Allergy Asthma Proc. 2003 Mar-Apr;24(2):85-9.