PMID- 21761958
OWN - NLM
STAT- MEDLINE
DCOM- 20111216
LR  - 20110718
IS  - 1936-2692 (Electronic)
IS  - 1088-0224 (Linking)
VI  - 17 Suppl 3
DP  - 2011 Apr
TI  - Emerging therapeutic options for asthma.
PG  - S82-9
AB  - Asthma is characterized by eosinophilic airway inflammation and elevated serum 
      immunoglobulin E (IgE) levels. Due to these pathologic features, the foundation 
      of asthma treatment has historically been anti-inflammatory therapy with inhaled 
      corticosteroids (ICSs). Numerous factors in addition to IgE and eosinophils, 
      however, likely play important roles in mediating the airway inflammatory 
      response characteristic of asthma. ICSs are effective therapy for some patients 
      with persistent asthma, but clinical trials have shown that even increasing doses 
      of ICSs under carefully controlled situations does not always result in 
      acceptable asthma control. Consequently, other classes of medications, in 
      addition to ICSs, are recommended in those patients with more severe asthma. The 
      class of medication most commonly used in more severe asthma, along with ICSs, is 
      long-acting inhaled beta2-agonists, but leukotriene modifying agents and anti-IgE 
      monoclonal antibodies may also be used. Agents such as tiotropium, a long-acting 
      inhaled anti-muscarinic agent, and those aimed at inhibiting cytokines, such as 
      mepoluzimab, daclizumab, and etanercept, hold promise in the treatment of asthma. 
      Other agents under investigation include phosphodiesterase type 4 inhibitors and 
      oligonucleotides. Bronchial thermoplasty, a nonpharmacologic option, may also be 
      beneficial in patients with poorly controlled asthma. As our understanding of the 
      complex pathophysiology of asthma increases, it will enable the development of 
      novel therapeutic approaches for patients who are not responding well to 
      traditional treatments. Although more studies are necessary to ensure the 
      efficacy and safety of both pharmacologic and nonpharmacologic approaches, there 
      is future promise for therapeutic advances in severe, persistent asthma.
FAU - Colice, Gene L
AU  - Colice GL
AD  - Washington Hospital Center, 110 Irving St NW, Washington, DC 20010, USA. 
      Gene.Colice@Medstar.net
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PL  - United States
TA  - Am J Manag Care
JT  - The American journal of managed care
JID - 9613960
RN  - 0 (Adrenal Cortex Hormones)
RN  - 0 (Adrenergic beta-1 Receptor Agonists)
RN  - 0 (Anti-Asthmatic Agents)
RN  - 0 (Cytokines)
RN  - 0 (Leukotriene Antagonists)
RN  - 0 (Phosphodiesterase 4 Inhibitors)
RN  - 37341-29-0 (Immunoglobulin E)
MH  - Adrenal Cortex Hormones/therapeutic use
MH  - Adrenergic beta-1 Receptor Agonists/therapeutic use
MH  - Anti-Asthmatic Agents/*therapeutic use
MH  - Asthma/blood/*drug therapy/pathology
MH  - Cytokines/antagonists & inhibitors
MH  - Drug Therapy, Combination
MH  - Eosinophils
MH  - Health Status Indicators
MH  - Humans
MH  - Immunoglobulin E/blood
MH  - Leukotriene Antagonists/therapeutic use
MH  - Phosphodiesterase 4 Inhibitors/therapeutic use
MH  - Severity of Illness Index
EDAT- 2011/07/27 06:00
MHDA- 2011/12/17 06:00
CRDT- 2011/07/19 06:00
PHST- 2011/07/19 06:00 [entrez]
PHST- 2011/07/27 06:00 [pubmed]
PHST- 2011/12/17 06:00 [medline]
AID - 48581 [pii]
PST - ppublish
SO  - Am J Manag Care. 2011 Apr;17 Suppl 3:S82-9.