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The variability of asthma

ABSTRACT Asthma is a chronic disease of airway inflammation that affects all age groups. Despite national treatment recommendations and the availability of effective controller medications, asthma morbidity remains pervasive and currently represents a considerable socio-economic burden. Asthma may be intermittent or persistent; persistent asthma may be mild, moderate, or severe. Many factors influence asthma severity, both on a short-term basis and over time. In individual patients, asthma severity may fluctuate because of physiologic, environmental, socioeconomic, or behavioral factors. Inhaled corticosteroids (ICSs) are safe and well tolerated, and are the preferred long-term treatment for controlling persistent asthma of all severities in adults and children. Awareness of episodic changes in asthma severity, with subsequent tailored adjustment in guideline-based ICS therapy, should enable optimal control of asthma with minimal medication requirements.