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Asthma

Therapy for Mild to Moderate Asthma

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JAMA
Published Online: July 21, 2022
JAMA Clinical Guidelines Synopsis
Sarah E. Gray, MD1;
Adam S. Cifu, MD1;
Valerie G. Press, MD, MPH1
Author Affiliations
  • 1University of Chicago, Chicago, Illinois
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Asthma is a disease characterized by recurring, reversible airways obstruction due to underlying inflammation and bronchial hyperresponsiveness. Asthma is one of the most common chronic noncommunicable diseases, affects an estimated 260 million people globally, and is associated with significant morbidity and mortality.1 Asthma with usually mild or infrequent symptoms (50%-75% of patients with asthma) contributes to 30% to 40% of exacerbations leading to emergency care; asthma-related death may occur in persons with asthma that is usually mild.2

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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

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Asthma Guidelines Pediatrics Pulmonary Medicine
Article Information

Corresponding Author: Adam Cifu, MD, the University of Chicago, 5841 S Maryland Ave, MC 3051, Chicago, IL 60637 (adamcifu@uchicago.edu).

Published Online: July 21, 2022. doi:10.1001/jama.2022.12258

Conflict of Interest Disclosures: Dr Press reported grants from NHLBI Association (R01HL146644), grants from Agency for Healthcare Research and Quality (R01HS027804), and grants from American Lung Association outside the submitted work; he also receives consultant fees from Vizient Inc and Humana. No other disclosures were reported.

References
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Dusser  D , Montani  D , Chanez  P ,  et al.  Mild asthma: an expert review on epidemiology, clinical characteristics and treatment recommendations.   Allergy. 2007;62(6):591-604. doi:10.1111/j.1398-9995.2007.01394.xPubMedGoogle ScholarCrossref
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Stanford  RH , Shah  MB , D’Souza  AO , Dhamane  AD , Schatz  M .  Short-acting β-agonist use and its ability to predict future asthma-related outcomes.   Ann Allergy Asthma Immunol. 2012;109(6):403-407. doi:10.1016/j.anai.2012.08.014PubMedGoogle ScholarCrossref
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Suissa  S , Ernst  P , Benayoun  S , Baltzan  M , Cai  B .  Low-dose inhaled corticosteroids and the prevention of death from asthma.   N Engl J Med. 2000;343(5):332-336. doi:10.1056/NEJM200008033430504PubMedGoogle ScholarCrossref
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O’Byrne  PM , FitzGerald  JM , Bateman  ED ,  et al.  Inhaled combined budesonide-formoterol as needed in mild asthma.   N Engl J Med. 2018;378(20):1865-1876. doi:10.1056/NEJMoa1715274PubMedGoogle ScholarCrossref
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Bateman  ED , Reddel  HK , O’Byrne  PM ,  et al.  As-needed budesonide-formoterol versus maintenance budesonide in mild asthma.   N Engl J Med. 2018;378(20):1877-1887. doi:10.1056/NEJMoa1715275PubMedGoogle ScholarCrossref
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Beasley  R , Holliday  M , Reddel  HK ,  et al; Novel START Study Team.  Controlled trial of budesonide-formoterol as needed for mild asthma.   N Engl J Med. 2019;380(21):2020-2030. doi:10.1056/NEJMoa1901963PubMedGoogle ScholarCrossref
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Sobieraj  DM , Weeda  ER , Nguyen  E ,  et al.  Association of inhaled corticosteroids and long-acting β-agonists as controller and quick relief therapy with exacerbations and symptom control in persistent asthma: a systematic review and meta-analysis.   JAMA. 2018;319(14):1485-1496. doi:10.1001/jama.2018.2769PubMedGoogle ScholarCrossref
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Patel  MR , Press  VG , Gerald  LB ,  et al.  Improving the affordability of prescription medications for people with chronic respiratory disease. an official American Thoracic Society policy statement.   Am J Respir Crit Care Med. 2018;198(11):1367-1374. doi:10.1164/rccm.201810-1865STPubMedGoogle ScholarCrossref
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Chapman  KR , An  L , Bosnic-Anticevich  S ,  et al.  Asthma patients’ and physicians’ perspectives on the burden and management of asthma.   Respir Med. 2021;186:106524. doi:10.1016/j.rmed.2021.106524PubMedGoogle ScholarCrossref
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