TY - JOUR T1 - The role of inhaled corticosteroids in the management of acute asthma JF - European Respiratory Journal JO - Eur Respir J SP - 1035 LP - 1037 DO - 10.1183/09031936.00119907 VL - 30 IS - 6 AU - B. H. Rowe AU - D. Vethanayagam Y1 - 2007/12/01 UR - http://erj.ersjournals.com/content/30/6/1035.abstract N2 - Acute exacerbations are common occurrences for asthmatics. Contact with airway irritants (e.g. viral upper respiratory tract infections, aero-allergens) and nonadherence to controller medications, along with the natural history of the disease can result in deterioration in lung function, increased symptoms and an increased need for reliever medication. It is estimated that nearly 2 million emergency department (ED) asthma visits occur annually in the USA alone 1. Since the frequency of exacerbations is related to asthma severity on the one hand, and increasing degrees of airway eosinophilia are associated with increased disease severity on the other 2, understanding the pathophysiology of exacerbations is critically important to disease control. The medical consequences of these events can range from minor life interruptions to severe illness. These severe exacerbations often result in ED presentation or unscheduled visits to health professionals for urgent care, and may require hospital admission. While rare, death from exacerbations does occur. The economic consequences of asthma have been well documented 3, 4 and the acute attack has been estimated to represent ∼25% of overall asthma costs 5. The control of chronic asthma with the use of inhaled corticosteroids (ICS), with or without the use of additional agents (e.g. long-acting β-agonists or leukotriene receptor antagonists), anticholinergics and in some cases newer biological agents, have proven effective in reducing the frequency and severity of these exacerbations. In addition, nonpharmacological approaches (regular follow-up, action plans, immunisation, asthma education) have also proven to be effective but adherence to these can be low 6, 7. Despite these advances, a gap between what is known and what is practiced hampers efforts to improve the quality of life of patients with asthma. This gap may be the result of poor access to care and resources, failure of physicians to treat the disease … ER -