New approaches to the treatment of childhood asthma.

In the past year, a number of important advances were made in the treatment of asthma, particularly with regard to children. New guidelines stress anti-inflammatory treatment early after diagnosis for patients who have persistent symptoms. Recent studies confirmed that inhaled steroids are the most efficacious therapy for children with mild asthma, although these same studies demonstrate the potential for adverse effects as well. Combination therapy with theophylline or salmeterol may allow clinicians to minimize the dose of inhaled steroids while controlling symptoms. New high-potency inhaled steroid preparations are clearly effective in the treatment of severely asthmatic patients, but they may cause significant side effects at higher doses. Anti-leukotriene medications may be helpful in the management of persistent asthma because they have been shown to improve asthma symptoms and pulmonary function. New directions in asthma therapy include treatment with monoclonal antibodies directed against IgE and specific cytokines involved in the inflammatory response in asthma.