PRESENT ROLE OF BETA-2-SYMPATHOMIMETICS I N THE TREATMENT OF BRONCHIAL-ASTHMA - LONG-TERM THERAPY VERSUS ON DEMAND THERAPY

On the basis of epidemiological data it was suggested that there is a causal relationship between an increasing use of beta-2-sympathomimeti c drugs and an increased morbidity and mortality from asthma. However, at the moment there is no definitive answer to the question whether a sthma therapy with short- or long-acting beta-2-adrenergic drugs shoul d be given continously or only on demand. Nevertheless, all eventual r isks of asthma therapy with beta-2-adrenergics should be taken into co nsideration because there is some prove that neither short- nor long-a cting beta-2-adrenergics have an antiinflammatory effect in vivo. Thus , they do not reduce bronchial hyperreactivity of the respiratory trac t and have either no effect or may even increase hyperreactivity. For the above mentioned facts and the epidemiological data we suggest the following drug regimen for treatment of asthma: Current regular antiin flammatory basic therapy of moderate and severe bronchial asthma is al ways required. If there is any necessity of additional antiobstructive therapy beta-2-adrenergics with short duration of action should be gi ven on demand. Only if under this regime asthma could not be protected an additional permanent antiobstructive therapy with beta-2-sympathom imetic drugs (e. g. long-acting drugs)should be considered.