The long-term influence of therapeutic interventions in asthma with emphasis on inhaled steroids and early disease.

The data available to show the long-term benefits of any pharmacological interventions in asthma is scanty. Usually the beneficial effects disappear gradually when the treatment is withdrawn. The evidence showing that treatment with drugs could change the natural course of asthma is largely lacking. Only a few controlled studies have lasted more than 1 year, while asthma can be a disease for life. Nevertheless, the short-term benefits of treatment with inhaled steroids justify their introduction as soon as the diagnosis of asthma is established. Regular use of inhaled steroids especially during the early stages of asthma often makes it a less troublesome disease. Regular use of long-acting beta2-agonists is useful in preventing exacerbations in persistent asthma, but their influence on the long-term outcome is quite unknown. Exploration of the possible disease outcome modifying effect of new innovations such as leukotriene antagonists should be put in the clinical study programmes. In future, the combination of immunological and pharmacological treatments may offer the key for more permanent results in asthma therapy.