On-Demand versus Maintenance Inhaled Treatment in Mild Asthma

U.S. and international guidelines for the treatment of mild persistent asthma recognize three distinct goals of therapy: to relieve and control symptoms, to prevent exacerbations, and to reduce loss of lung function, with minimal side effects.^1,2 Short-acting beta-agonists (SABAs), such as albuterol and terbutaline, achieve the first goal, because they relieve symptoms rapidly. Long-acting beta-agonists (LABAs) provide symptom control for 12 to 24 hours, but beta-agonists offer only symptom relief. Accordingly, inhaled glucocorticoids are recommended for the other goals of therapy. Inhaled glucocorticoids reduce the incidence and severity of symptoms, prevent exacerbations, and reduce airway remodeling — effects that are . . .