Which goals for the asthma treatment: symptoms, inflammation, lung function?

Asthma is a complex inflammatory disease, much having been learned about its pathophysiology and its treatment in recent years. The goal of therapy, as recommended by various consensus conferences, is to achieve control of the disease, both clinical (no or minimal symptoms) and functional (normal FEV1 and PEF). Given the present knowledge about bronchial inflammation, that it may begin very early in the natural course of the disease and be accompanied by bronchial remodelling, these goals may be insufficient, especially in the case of children. As a result, there is much debate on what are the "best" parameters to define asthma control: pulmonary function, bronchial responsiveness, markers of inflammation, quality of life, etc. Another important goal is to achieve optimal control with minimal or no secondary drug effects. (C) 2004 Elsevier SAS. Tous droits reserves.