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Respiratory Care

Inhaled Management of Asthma

Welcome to the Inhaled Management of Asthma section of the Respiratory Care Learning Zone!

Find the latest updates on inhaled medications for the treatment of asthma (including their place in the 2020 updated Global Initiative for Asthma [GINA] strategy), targets for treatment and the importance of inhaler devices in drug delivery.

Unmet need in asthma and patient considerations

Patients still suffer from symptoms of asthma despite the availability of effective treatments. Explore the unmet needs in asthma.

 

Image 5_Inhaled therapies in asthma.jpgOver one-third of patients with asthma are uncontrolled on inhaled corticosteroid (ICS)/long‑acting β2‑agonist (LABA) therapy,1,2 placing them at risk of exacerbations and hospitalisation and negatively impacting their quality of life.3–5

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Improving treatment for asthma: control of airway inflammation and bronchodilation

Asthma is a chronic inflammatory disorder of the airways involving many different types of cells and cellular elements. In this section you can learn about how inhaled corticosteroids target inflammation in asthma and bronchodilators address bronchoconstriction. In combination, inhaled therapies have the potential to deliver control of inflammation and comprehensive bronchodilation in order to optimise outcomes in patients with asthma.

 

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Asthma is a heterogeneous disease, often driven by chronic airway inflammation (Figure 1) and characterised by airway smooth muscle (ASM) contraction which is responsible for bronchoconstriction. This causes symptoms such as wheezing and breathlessness.1,2 The worsening of these symptoms results in asthma exacerbations.3

 

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Inhaler devices

It’s critical that inhaled medication is delivered in an inhaler the patient can actually use. In this section you can read about the range of inhalers available for delivery of asthma medication and factors to consider when deciding on an inhaler for an individual patient.

 

Image 4_Inhaled therapies in asthma.jpgInhaled treatment is the preferred route of delivery for asthma medication as inhalers deliver drugs rapidly and directly to the airways.1 Controller inhalers contain anti‑inflammatory medication such as inhaled corticosteroid (ICS) and are used on an as-needed or daily basis, depending on the severity of asthma, whereas reliever inhalers aim to relieve symptoms quickly.1

 

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GINA strategy recommendations

What is the place of inhaled medications in the treatment of asthma? Scroll down to find out about recommendations in the 2019 updated Global Initiative for Asthma (GINA) strategy!

 

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Inhaled therapies underpin the GINA strategy stepwise approach to asthma management (Figure 1).1 

The updated 2019 GINA strategy advises that all adults and adolescents with asthma should receive inhaled corticosteroid (ICS)‑containing controller therapy to reduce their risk of exacerbations and control symptoms.1 Patients should be encouraged to adhere to their controller medication even when symptoms are infrequent, to reduce or eliminate the need for reliever therapy.

 

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Recent clinical trials

Recommendations for inhaled therapies for patients with asthma are continually evolving, based on the latest evidence and understanding of the disease. In this section, you can discover up-to-date information on recent and ongoing clinical trials exploring the efficacy and safety profiles of long-acting β2-agonist/long-acting muscarinic antagonist/inhaled corticosteroid (LABA/LAMA/ICS) and LABA/ICS combination therapies.

 

Image 3_Inhaled therapies in asthma.jpg(Image is of a model, used for illustrative purposes only.)

Research continues apace to provide insights into the role of inhaled combination therapies in asthma.

Table 1 summarises available information on the study designs and key results for recent clinical trials investigating the use of new LABA/LAMA/ICS combination therapies for the treatment of asthma.

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