Japanese Guideline for Adult Asthma

Abstract

Adult bronchial asthma (hereinafter, asthma) is characterized by chronic airway inflammation, reversible airway narrowing, and airway hyperresponsiveness. Long-standing asthma induces airway remodeling to cause an intractable asthma. The number of patients with asthma has increased, while the number of patients who die from asthma has decreased (1.7 per 100,000 patients in 2009). The aim of asthma treatment is to enable patients with asthma to lead a healthy life without any symptoms. A partnership between physicians and patients is indispensable for appropriate treatment. Long-term management with agents and elimination of causes and risk factors are fundamental to asthma treatment. Four steps in pharmacotherapy differentiate mild to intensive treatments; each step includes an appropriate daily dose of an inhaled corticosteroid (ICS), varying from low to high doses. Long-acting β(2) agonists (LABA), leukotriene receptor antagonists, and theophylline sustained-release preparation are recommended as concomitant drugs, while anti-IgE antibody therapy is a new choice for the most severe and persistent asthma. Inhaled β(2) agonists, aminophylline, corticosteroids, adrenaline, oxygen therapy, etc., are used as needed against acute exacerbations. Allergic rhinitis, chronic obstructive pulmonary disease (COPD), aspirin induced asthma, pregnancy, and cough variant asthma are also important factors that need to be considered.

Importance of Inhaler Device Use Status in the Control of Asthma in Adults: The Asthma Inhaler Treatment Study

“…Therefore, finding the best way to assess asthma control and defining management strategies are the ongoing challenges in asthma management to ensure that asthma control is achieved and maintained. 4 In line with the newly introduced asthma management approach, which emphasizes the monitoring of disease control to facilitate acceptance and use of asthma guidelines in clinical practice, 5 the use of combined therapies in which inhaled corticosteroids are given mainly in combination with long-acting beta-2 adrenoceptor agonists [5][6][7] has been recommended. However, correct inhalation technique plays a vital role in effective asthma therapy, alongside appropriate drug usage, 8 which otherwise may lead to diminished therapeutic effect, poor control of symptoms, and therefore insufficient disease management.…”

Exacerbation of daily cough and allergic symptoms in adult patients with chronic cough by Asian dust: A hospital-based study in Kanazawa

“…We excluded four of these patients because they were current smokers, and we analyzed the data from the remaining 86 subjects. Asthma was diagnosed on the basis of the Japan Asthma Prevention and Management Guidelines 2011 (Ohta et al, 2011). Cough variant asthma was diagnosed according to the criteria of the Japanese Cough Research Society (Kohno et al, 2006), and atopic cough was diagnosed according to previously reported criteria (Fujimura et al, 1992), which is based on a cough resistant to the use of bronchodilators and cough resolution with the use of histamine H1 antagonists and/or inhaled corticosteroids.…”

“…Asthma is a chronic airway inflammatory condition characterized by repetitive cough, wheezing, dyspnea, reversible airway narrowing and airway hyperresponsiveness (Ohta et al, 2011). The prevalence of asthma amongst Japanese adults has increased over the past 10 years (Fukutomi et al, 2010), and in recent years, the number of patients who suffer from chronic cough without wheezing or dyspnea has also increased.…”

Asthma Control and Management Changes in Japan: Questionnaire Survey

“…The social and economic burden of asthma remains heavy and needs to be immediately addressed (5,6). Therefore, there is a need for determining the various problems concerned with asthma, includ- ing the relationship with chronic obstructive pulmonary disease, the management of aspirin intolerant asthma and cough variant asthma, as a part of asthma management (3,7). Moreover, the management and the treatment of asthma can greatly differ according to the time and the surrounding environment and, in fact, the guidelines for asthma have been revised several times (3,7,8).…”

“…Therefore, there is a need for determining the various problems concerned with asthma, includ- ing the relationship with chronic obstructive pulmonary disease, the management of aspirin intolerant asthma and cough variant asthma, as a part of asthma management (3,7). Moreover, the management and the treatment of asthma can greatly differ according to the time and the surrounding environment and, in fact, the guidelines for asthma have been revised several times (3,7,8). It is important to obtain exact information about the actual clinical situations concerned with the management and the treatment of asthma to accomplish the best revision of the guidelines.…”