Frezet Massimo Mosca, Braida Alessandro, Dore Maurizio, Gani Federica
Clinica di Malattie dell'Apparato Respiratorio, Servizio di Allergologia Respiratoria Azienda Ospedaliera San Luigi Orbassano, Torino.
Recenti Prog Med. 2004 Jun;95(6):289-96.
Nowadays asthma treatment is based on topical beta2 short-acting and topical and systemic corticosteroids. Topical drugs do not control completely peripheral airways inflammation and also they are not able to control other disease frequently associated to asthma as rhinitis. Systemic steroids instead are very useful but not specific antinflammatory drug and can induce important side effects. For the reasons mentioned above it is important to use systemic drugs, acting on the numerous mediators typical of asthma, without modifying human physiological functions. We actually can use antileucotriens, but anti-IgE will be available also in Italy soon. Antileucotriens are effective and safe and are actually used in persistent asthma not completely controlled by inhaled steroids. They are administered per os; some of them are used once a day and can be used in paediatric age. In USA antileucotriens are also indicated in allergic rhinitis treatment. In atopic asthma, Omalizumab, an anti IgE drug, is safe and useful. It reduces the use of the systemic and inhaled steroids and the number of asthma exacerbations, in selected treated patients, without inducing important side effects. It is also useful in the treatment of rhinitis. Some proinflammatory cytochines, antiinflammatory cytochines and phosphodiesterasis inhibitor could be useful in the treatment of asthma but actually the use of these new drugs is still experimental.