In response to the increase in asthma morbidity and mortality noted in the 1980s, the National Heart, Lung, and Blood Institute convened an expert panel and published its recommendations as the National Asthma Education Program in 1991.1 Comprehensive guidelines were developed focusing on four components of asthma management:

1. Objective measures of lung function

2. Pharmacologic therapy

3. Environmental measures to control allergens and irritants

4. Patient education

This commentary addresses issues related to pharmacologic therapy. The guidelines of this component of asthma management focus on treatment of inflammation, rather than on bronchodilation. Because corticosteroids are the most effective anti-inflammatory agents used to treat asthma, there has been a shift to using inhaled corticosteroids.

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