Asthma and Arthritis: Are there any similarities?

Asthma Asthma is a serious global health problem that is broadly distributed by age, sex, race/ethnicity, and geographic location. International statistics indicate that asthma prevalence, morbidity, and mortality have increased significantly since the early 1970s. whereas some studies indicate continued increases through the mid 1990s, others show recent downward trends, especially in asthma hospitalizations and mortality. Among possible contributors to the observed trends are patterns of drug therapy. Therefore it would seem that patient outcomes in asthma depend strongly on appropriate medication use. Traditionally, symptomatic relief of bronchospasm with short-acting 2 agonists was the mainstay of therapy. Numerous studies, however, suggest that this therapy alone is ineffective and that regular use of 2 agonists might actually increase the risk of morbidity and mortality. Not until the early 1990s was inflammation widely recognized as the predominant cause of reversible airway obstruction and airway hyper-reactivity. As a result, treatment has shifted to the early and regular use of anti-inflammatory “controller” medications (especially inhaled corticosteroids) for control of airway inflammation. Short-acting 2 agonists and other “reliever” medications are now recommended for as-needed use for relief of acute bronchoconstriction. Appropriate use of inhaled corticosteroids is associated with improved patient outcomes. Many studies in the last decade, however, suggested underprescription and underutilization of inhaled corticosteroids. Therefore, chronic inflammatory diseases such as asthma, and the changing treatment paradigms have proven to be a classic case study of metamorphosis. Evolving from treating asthma initially with 2 stimulants and using corticosteroids only during exacerbations, to present day current asthma guidelines that advocate corticosteroids therapy early followed by ß2 stimulants (“hit early, hit hard”).