Nabel pointed out that since the last guidelines were issued, there has been increased understanding of asthma and better approaches to diagnosis and treatment. Although more people are being diagnosed with the disease, the number of people reporting asthma attacks has remained stable, and deaths have dropped, she noted.
To focus on the severity and future risk of asthma attacks, the new guidelines establish new age categories that enable doctors to pursue three different treatment plans. The categories are: infants to 4 years old, 5 to 11 years old, and 12 and older. The 5 to 11 age group was added (earlier guidelines combined this group with the adults), following new evidence on medications for this age group and findings that suggest children may respond differently than adults to asthma medications.
Treatment steps have also been expanded from four to six, said Dr. William W. Busse, head of the panel that developed the guidelines and chairman of the University of Wisconsin's Department of Medicine.
"In persistent asthma, inhaled corticosteroids remain the preferred foundation for anti-inflammatory therapy," Busse said during the teleconference.
The guidelines also call for allowing children to bring their rescue inhalers to school in case of an asthma attack.
Other new steps are geared to people 12 and older with severe asthma. These steps include the addition of the drug omalizumab, a monoclonal antibody that targets immunoglobulin E, which is associated with allergic reactions, Busse said.
The guidelines also stress the importance of teaching patients to self-monitor and manage their asthma. They recommend using a written asthma action plan, which features instructions for daily treatment and ways to recognize and handle worsening asthma.
"Our hope is that these guidelines will help even more asthma patients feel better so they can lead active, full lives, not restrict their ac
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