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Back Aims of treatment Living with asthma can be challenging, and unfortunately, there is currently no cure. However, most people can effectively manage the condition through a combination of medications, lifestyle changes, preventive measures, and support. The primary goal of treatment is to control your symptoms, improve your lung function, and prevent asthma attacks. In the long run, good asthma control will help prevent a decline in your lung function. Controlling symptoms means they no longer interfere with your daily life. Your healthcare provider will work with you to review your symptoms and to adjust your treatment plan accordingly. With new treatment options emerging, the medical field is shifting its focus toward a new goal: asthma remission. Asthma remission is a state in which symptoms are minimal or even completely absent for an extended period. The medical community is optimistic that achieving remission will become possible for more patients in the future. What does symptom control mean? If your treatment is working well, you can expect: No asthma attacks No asthma symptoms (chest tightness, coughing, wheezing, or shortness of breath) during the day Rare to no nighttime awakenings due to asthma Reduced need for your reliever inhaler To be able to perform daily activities (including exercise) without experiencing asthma symptoms Good lung function To evaluate your asthma control, your healthcare provider might ask you to keep an asthma control diary at home or complete an asthma control questionnaire. This will help your doctor to adjust your treatment until good asthma symptom control is achieved. You can download a copy of these documents for personal use here (permission to distribute for personal use only!): Get the Questionnaire Get the Diary Asthma treatment usually involves a combination of maintenance/controller and reliever medications. Most medications come in an inhaler, while others are taken in the form of tablets or in some cases even injections. A combination of medications is frequently needed to increase their efficacy and to reduce side effects. This can be achieved by using multiple inhalers or by using a single device that delivers a combination of medicines. Maintenance/controller treatment A lot of people with asthma will have to use maintenance or long-term controller medications. These are medications that are taken daily to reduce the inflammation in the airways, prevent asthma symptoms, and minimise the risk of asthma flare-ups. Inhaled steroids (also known as glucocorticoids or corticosteroids) How do they work? Inhaled steroids decrease inflammation in the airways over time. Inhaled steroids reduce the frequency of asthma symptoms, improve your quality of life, decrease the risk of serious asthma flare-ups, and prevent lung function decline over time. Most common side effects? Inhaled steroids work locally in the airways, at the site of the inflammation. Hence, only a very low dose enters the bloodstream, leading to few side effects. Oral thrush (a yeast infection in the mouth) is the most common side effect, which you can prevent by rinsing and gargling with water after using your inhaler. Hoarseness or a sore throat can also occur, but is less common. These side effects can often be managed by switching to a different type of inhaler or by incorporating the use of a spacer device. People with severe asthma may need higher doses, which can increase the risk of rare long-term side effects like osteoporosis or cataracts. Your doctor will always try to keep your dose as low as possible to reduce the risk. If you’re ever concerned about side effects, talk to your healthcare provider. Long-acting beta-agonist (LABA) + inhaled steroids How do they work? Long-acting beta-agonists, also called long-acting bronchodilators, relax the muscles around the airways to help open them up. LABAs work for over 12 hours, with some working within minutes (formoterol), while others can take several hours before reaching their maximal effect (like salmeterol). These types of inhalers should always be used alongside inhaled steroids, because they don’t act on the underlying inflammation. A single inhaler containing both an inhaled steroid and the long-acting beta-agonist formoterol can be used as a daily controller medication and may also be used as a quick reliever of asthma symptoms. This convenient approach is called ‘Maintenance and Reliever Therapy (MART)’. Not all combination inhalers are suitable for use in case of an asthma flare-up, so make sure to check with your doctor which treatment to use as a reliever. Most common side effects? There are very few common side effects, and the side effects tend to get better after using the inhaler for a few weeks. You might notice headaches, a faster heart rate or feeling shaky. Correct inhaler technique and the use of a spacer can help avoid side effects. If you’re ever concerned about side effects, talk to your healthcare provider. Leukotriene modifiers How do they work? Leukotriene modifiers, like montelukast, work by opening narrowed airways, decreasing the level of inflammation, and lowering mucus production. This medication is taken in the form of tablets. They are typically less effective in controlling asthma compared to inhaled steroids, but they are sometimes used as an alternative for mild asthma, particularly in patients with other allergy symptoms that are also responsive to this type of medication. Most common side effects? They have very few common side effects, but agitation or depression have been described. If you’re ever concerned about side effects, talk to your healthcare provider. Long-acting muscarinic antagonist (LAMA) How do they work? Long-acting muscarinic antagonists (LAMAs) work by relaxing the muscles around the airways. LAMAs are a type of long-acting bronchodilator. If you already use an inhaled steroid plus a LABA and your asthma still is not controlled, your healthcare provider may add a LAMA. Most common side effects? The most common side effect is dry mouth. Take frequent sips of water or try stimulating saliva production by chewing some sugar-free gum or sucking on sugar-free hard candy. If you’re ever concerned about side effects, talk to your healthcare provider. Reliever treatment Relievers, also called quick-relief medications, are inhalers that contain a kind