Emerging Issues in the Management of Asthma

Asthma is a chronic lung disease caused by inflammation and tightening around the airways, which makes it harder to breath.Multiple environmental and genetic factors are implicated in the aetiology of asthma.Asthma is normally mediated by IgE and precipitated by an allergic response to an allergen.The diagnosis of asthma is based on medical history, physical examination, lung function testing and response to medication.Children and adults with a high probability of asthma usually start a treatment trial, where their response is assessed using spirometry.Children and adults with an intermediate probability of asthma usually have lung function tests conducted, such as spirometry, peak flow and airway responsiveness.The Global initiative for asthma goal of asthma management is to achieve the best possible long-term outcomes for the individual patient.This may include good long-term symptom control (few/no asthma symptoms, no sleep disturbance due to asthma, and unimpaired physical activity), and minimised long-term risk of asthma-related mortality, exacerbations, persistent airflow limitation and side-effects of treatment.The patient's own goals should also be identified.At each treatment step in asthma management, different medication options are available that, although not of identical efficacy, may be alternatives for controlling asthma.Different considerations apply to recommendations or choices made for broad populations compared with those for individual patients.In addition to pharmacological treatments, other strategies should be considered where relevant, to assist in improving symptom control and/or reducing future risk.