Revisiting asthma pharmacotherapy: where do we stand and where do we want to go?

Several current guidelines/strategies outline a treatment approach to asthma, which primarily consider the goals of improving lung function and quality of life and reducing symptoms and exacerbations. They suggest a strategy of stepping up or down treatment, depending on the patient's overall current asthma symptom control and future risk of exacerbation. While this stepwise approach is undeniably practical for daily practice, it does not always address the underlying mechanisms of this heterogeneous disease. In the last decade, there have been attempts to improve the treatment of severe asthma, such as the addition of a long-acting antimuscarinic agent to the traditional inhaled corticosteroid/long-acting β

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Déclaration de conflit d'intérêts

Conflict of interest: M. Cazzola participated as a faculty member and advisor in scientific meetings and courses under the sponsorship of Abdi Ibrahim, Alkem, Almirall, AstraZeneca, Boehringer Ingelheim, Chiesi Farmaceutici, Cipla, GlaxoSmithKline, Glenmark, Lallemand, Mankind Pharma, Menarini Group, Mundipharma, Novartis, Pfizer, Recipharm, Sanofi, Teva, Verona Pharma and Zambon, and is or was a consultant to ABC Farmaceutici, AstraZeneca, Chiesi Farmaceutici, GlaxoSmithKline, Lallemand, Novartis, Ockham Biotech, Recipharm, Verona Pharma and Zambon. C.P. Page has acted as a consultant to Eurodrug, Recipharm, Glycosynnovation and PrEP Biopharma, and also holds equity in Verona Pharma. M.G. Matera participated as a faculty member and advisor in scientific meetings and courses under the sponsorship of ABC Farmaceutici, Almirall, AstraZeneca, Chiesi Farmaceutici, GlaxoSmithKline and Novartis, was a consultant to Chiesi Farmaceutici and GlaxoSmithKline, and her department was funded by GlaxoSmithKline and Novartis. P. Rogliani has participated as a faculty member and advisor in scientific meetings and courses under the sponsorship of Almirall, AstraZeneca, Biofutura, Boehringer Ingelheim, Chiesi Farmaceutici, GlaxoSmithKline, Menarini Group, Mundipharma, Novartis, Recipharm, Sanofi and Zambon, and her department was funded by Almirall, Boehringer Ingelheim, Chiesi Farmaceutici, Novartis and Zambon. N.A. Hanania received honoraria for serving as advisor or consultant for GlaxoSmithKline, AstraZeneca, Sanofi, Regeneron, Amgen, Genentech, Novartis and Teva, and his institution received research grant support on his behalf from GlaxoSmithKline, Genentech, Sanofi, Teva, Novartis and AstraZeneca. The authors have no other relevant affiliations or financial involvement with any organisation or entity with a financial interest in, or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.