There is an unmet need in current asthma guidelines for those individuals who exhibit the small airways asthma phenotype with FEV1 but abnormal forced midexpiratory flow and peripheral airway resistance, which tends to be associated with poorer control.
Extrafine hydrofluoroalkane solution formulations of inhaled corticosteroid either alone or in combination with long-acting beta-agonist may improve small airways outcomes and associated control.
From a pragmatic perspective, it makes sense to try to deliver asthma treatment to more of the lung to improve clinical outcomes, especially in patients who exhibit the small airways asthma phenotype.
It remains to be seen of this “pragmatic perspective” is confirmed by clinical trials.
Targeting the small airways asthma phenotype: if we can reach it, should we treat it? Brian Lipworth, MD. Annals of Allergy, Asthma & Immunology, Volume 110, Issue 4 , Pages 233-239, April 2013.
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