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April 22, 1992

International Consensus Report Urges Sweeping Reform in Asthma Treatment

JAMA. 1992;267(16):2153-2154. doi:10.1001/jama.1992.03480160011002

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AN INTERNATIONAL panel of asthma experts is advising physicians to adopt a sweeping philosophical change in the way they manage asthma. Treat asthma not as an episodic, bronchospastic disorder, they suggest, but as a chronic, persistent disease with inflammation at its core.

That is the word from the International Asthma Management Project, a working group of 18 physicians and scientists convened by the National Heart, Lung, and Blood Institute, Bethesda, Md, in their now-released report on the diagnosis and management of asthma.

In what is termed an international consensus, the report recommends regular use of anti-inflammatory drugs, preferably inhaled corticosteroids, as first-line therapy for anything more than occasional mild asthma. β2-Agonist bronchodilators, commonly used in the United States as regularly scheduled, first-line therapy, are endorsed only for the pretreatment of exercise-induced asthma and for the symptomatic relief of acute exacerbations, or "asthma attacks," when anti-inflammatory therapy is insufficient.