Bronchodilators and anti-inflammatory compounds. Over the next decade bronc
hodilators and anti-inflammatory compounds will continue to be central for
the therapy of asthma in childhood. The antiinflammatory cromolyn and nedoc
romil are clearly inferior to inhaled corticosteroids. New developments inc
lude combinations of steroids with long acting beta -agonists and hydrofluo
ralkan driven metered dose inhalers which in case of beclomethasone, produc
e a reduced aerosol droplet size with a more peripheral pattern of depositi
on.
Leukotriene receptor antagonists. The leukotriene receptor antagonist Monte
lukast belongs to a new class of anti-inflammatory asthma medication that i
s on the German market since 1998. A single daily evening dose will support
compliance with treatment, however much more studies are necessary to defi
ne the position of this drug in the treatment of pediatric asthma.
Antibodies. The rare cases of asthma dependent on oral steroids may benefit
from the anti-IgE-antibody rhuMAb-E25. Several new approaches relying on t
he blockade of the action of cytokins central for the pathogenesis of asthm
a are very promising, however the results of larger phase III/IV studies mu
st be awaited.