Mild asthma: an expert review on epidemiology, clinical characteristics and treatment recommendations

This review is the synthesis of a working group on mild asthma. Mild asthma includes intermittent and persistent mild asthma according to the Global Initiative for Asthma (GINA) classification, and affects between 50% and 75% of asthmatic patients. Mild asthma is more frequent, more symptomatic, and...

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Bibliographic Details
Published in:Allergy 2007-06, Vol.62 (6), p.591-604
Main Authors: Dusser, D, Montani, D, Chanez, P, de Blic, J, Delacourt, C, Deschildre, A, Devillier, P, Didier, A, Leroyer, C, Marguet, C, Martinat, Y, Piquet, J, Raherison, C, Serrier, P, Tillie-Leblond, I, Tonnel, A.-B, Lara, M.T. de, Humbert, M
Format: Article
Language:English
Subjects:
Administration, Inhalation
Adrenal Cortex Hormones - administration & dosage
Adult
Age Factors
Asthma - drug therapy
Asthma - epidemiology
Asthma - physiopathology
Bronchodilator Agents - administration & dosage
Child
clinical signs
Clinical Trials as Topic
epidemiology
Humans
mild asthma
pathophysiology
physiopathology
signs and symptoms (animals and humans)
treatment
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Summary:This review is the synthesis of a working group on mild asthma. Mild asthma includes intermittent and persistent mild asthma according to the Global Initiative for Asthma (GINA) classification, and affects between 50% and 75% of asthmatic patients. Mild asthma is more frequent, more symptomatic, and less well controlled in children than in adults. Cohort studies from childhood to adulthood show that asthma severity usually remains stable over time. Nevertheless, mild asthma can lead to severe exacerbations, with a frequency ranging from 0.12 to 0.77 per patient-year. Severe exacerbations in mild asthma represent 30-40% of asthma exacerbations requiring emergency consultation. In mild asthma, inflammation and structural remodelling are constant, of varying intensity, but nonspecific. Therapy with inhaled corticosteroids (ICS) decreases bronchial inflammation, but has only a slight effect on structural remodelling, and, when stopped, inflammation immediately recurs. Permanent low-dose ICS therapy is the reference treatment for persistent mild asthma. Effectiveness is to be reassessed at 3 months, and if it is insufficient the patient is no longer considered mildly asthmatic, and treatment has to be stepped up. As mild asthma is the most frequent form of the disease, diagnosis and management require physicians' particular attention.
ISSN:0105-4538
1398-9995
0108-1675
DOI:10.1111/j.1398-9995.2007.01394.x