“Time flies” is a frequent refrain particularly from someone who has been around for a while. It seems like only yesterday the use of inhaled corticosteroids was found to be helpful in treating patients with asthma. There was initial resistance from both the medical field and patients concerning what at the time was a new concept in therapy.
Today inhaled corticosteroids are the mainstay of asthma management. To be clear, using these inhaled medications does not cure asthma nor prevent its development. The first oral and then inhaled corticosteroids were brought into clinical use by a Dr. H.M. Brown following an article he published in the British Medical Journal in 1972. Since Dr. Brown’s studies and observations physicians have learned a great deal about the use of inhaled corticosteroid therapy in our asthma patients.
The first thing we learned to do is make sure your patient has asthma. Having an accurate diagnosis is always important in treating any disease. We now know that biomarkers (things found in the blood such as cells called eosinophils) can help decision making in selecting the optimal inhaled regimen. Most patients can have their asthma controlled with low to medium doses of inhaled corticosteroids and if systems persist adding on additional types of therapy is more effective than raising the dose of the corticosteroid.
We have come a long way from 1972 in our understanding of the asthmatic disease process and ways to keep our patients symptom free.
