Treatment of mild asthma: Is it necessary to keep regular inhaled corticosteroids?

ABSTRACT

The main goal of asthma treatment is an adequate control of symptoms and a reduction in future exacerbations. To achieve the goal, international guidelines recommend daily use of controllers, such as inhaled corticosteroids (ICSs), even in patients with mild asthma. However, poor adherence is an unavoidable issue in the management of mild asthma. In addition, there is concern about possible adverse reactions and economic burden by unnecessary treatment. Recently, several studies have shown that as-needed use of ICSs has similar effects as regular use of ICSs on the prevention of acute asthmatic exacerbations. However, daily regular use of ICSs seems to be superior in terms of symptom-free days or airway inflammation suppression. Further studies are needed to determine whether symptom-driven use of ICSs can be an effective strategy for the management of mild asthma. Also, it is necessary to develop proper methods that can predict mild asthmatics who experience frequent exacerbations if they stop regular ICSs.