Bronchial asthma. Long-term therapy and prognosis

Bronchial asthma is not a disease entity but a nonspecific reaction of the lung characterized by recurrent reversible airway obstruction. Successful treatment depends on identification of the type of asthma according to causative factors such as allergens, respiratory tract infections, complicating factors (sinusitis, smoking parents) and the degree of severity. For allergic or mixed asthma the identification and elimination of relevant allergens may be the only therapy required. Drugs for long-term treatment are Beta-2-mimetics, chromolynglycate and theophylline as a slow-release preparation. Corticosteroids should only be used after failure of these drugs, following the exclusion of complicating factors and for limited periods of time. Specific Hyposensitization is suited for moderate to severe types of pollen-induced asthma. Hyposensitization against non-pollen-allergens is of doubtful value. Estimates on the persistence of asthmatic symptoms into adulthood range between 26% and 78%. An earlier age of onset of asthma means a better prognosis except when asthma begins under two years of age. Concurrent atopic dermatitis or atopic rhinitis increase the probability that asthma will persist into adulthood.