Evidence-based pharmacologic treatment for mild asthma

Background: Although mild asthmatics form the majority of asthma sufferers, there is a relative paucity of evidence-based treatment compared with severe asthmatics. Objective: We have performed an up-to-date review of the literature on therapy in this group of patients who form an overlooked but important majority. Potential trials were identified through MEDLINE (1965-2007) and Cochrane library (up to February 2007). Discussion: Recent trials have shown that inhaled corticosteroids (ICS) remain the cornerstone of treatment for patients with mild persistent asthma. Early intervention with ICS decreases the risk of severe exacerbations and improves asthma control in patients with mild persistent asthma of recent onset. ICS are superior to leukotriene receptor antagonists and xanthines for control of asthma and in the improvement of lung functions. The addition of long-acting beta(2)-agonist may be considered in those with moderately persistent asthma or whom asthma is not well controlled with low doses of ICS.