10/13/2023 0 Comments Lama laba aafpOmalizumab (Xolair) may be used to decrease severe exacerbations and oral corticosteroid use in patients with allergic asthma. 40 – 43Ĭonsistent evidence showing reduced symptom scores and rescue medication use with subcutaneous immunotherapy and lack of evidence for sublingual immunotherapy for patient-oriented outcomes Subcutaneous immunotherapy should be considered as an adjunct treatment for individuals five years and older with mild to moderate allergic asthma, but sublingual immunotherapy is not recommended. 2, 31, 36Ĭonsistent results in multiple meta-analyses showing reduced rates of asthma exacerbations Single maintenance and reliever therapy is the preferred treatment for moderate asthma in adolescents and adults. Mixed evidence from multiple randomized controlled trials evaluating patient-oriented outcomes Biologic agents may be considered for patients with severe allergic and eosinophilic asthma.Īdding a long-acting beta 2 agonist to inhaled corticosteroid therapy is preferred over adding long-acting muscarinic antagonists however, long-acting muscarinic antagonists may be added as triple therapy for severe persistent asthma. Patients with severe uncontrolled asthma despite appropriate treatment should be reassessed and considered for specialty referral. Subcutaneous immunotherapy may be considered for those five years and older with mild to moderate allergic asthma however, sublingual immunotherapy is not recommended. This therapy is preferred for adults and adolescents because of its effectiveness in reducing severe exacerbations. Single maintenance and reliever therapy combines an inhaled corticosteroid and long-acting beta 2 agonist for controller and reliever treatments. Treatment typically begins with inhaled corticosteroids, and additional medications or dosage increases should be added in a stepwise fashion according to guideline-directed therapy recommendations from the National Asthma Education and Prevention Program or the Global Initiative for Asthma when symptoms are inadequately controlled. Controller medications consist of inhaled corticosteroids, long-acting beta 2 agonists, long-acting muscarinic antagonists, and leukotriene receptor antagonists. Short-acting beta 2 agonists are preferred asthma reliever medications. Asthma severity and level of control should be assessed at diagnosis and evaluated at subsequent visits using validated tools such as the Asthma Control Test or the asthma APGAR (activities, persistent, triggers, asthma medications, response to therapy) tools. Asthma affects more than 25 million people in the United States, and 62% of adults with asthma do not have adequately controlled symptoms.
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