Is daily inhaled steroid use necessary in the treatment of mild persistent asthma?
Matthew B. Stanbrook Division of Respirology, Department of Medicine, University Health Network, University of Toronto, Toronto, Ont. Boushey HA, Sorkness CA, King TS, Sullivan SD, Fahy JV, Lazarus SC, et al. Daily versus as-needed corticosteroids for mild persistent asthma. N Engl J Med 2005;352:1519-28. Background: For years, daily anti-inflammatory therapy has been recommended for all cases of mild persistent asthma, yet asthma patients commonly fail to adhere to this daily regimen. Whether intermittent use can produce acceptable outcomes in this population is unknown. Design: This multicentre, randomized, double-blind trial enrolled 225 adults with mild persistent asthma (defined as a forced expiratory volume in the first second [FEV1] at least 70% of the predicted value, plus 1 or more of: as-needed ß-agonist use more than twice a week but not daily; nocturnal awakening with asthma more than twice a month but not weekly; and variability in diurnal peak expiratory flow [PEF] of 20%
