Formoterol - where does it fit in the current guidelines?

Drugs available to treat asthma have improved considerably over the past th ree decades and understanding of the disease process is continually improvi ng. However, the incidence of asthma is increasing and the cause(s) of this increase are not yet identified. Asthma is often underdiagnosed and undert reated. Poor compliance with medication is also an important consideration in how effective management strategies can be. The aim of current asthma tr eatment, according to the Global Initiative for Asthma (GINA), is to contro l the disease. However, two surveys. one in Europe and the other in the U.S .A. indicate that the objectives of treatment guidelines are not being met. Patients were shown to experience high rates of exacerbations and require many doses of reliever medication. There was also a large difference betwee n patient and physician perceptions of treatment-this needs to be countered by improved education for both the general public and healthcare professio nals. Formoterol, which is the only beta (2)-agonist to possess both fast- and long-acting properties, may help to improve patient compliance by allow ing a single inhaler to be used for both maintenance and as-needed therapy However, although formoterol is already widely used as maintenance therapy, current treatment guidelines do not include the use of formoterol as first -line reliever medication. Evidence is increasing to support as-needed use and a large, randomized effectiveness study in 18000 patients across the wo rld is ongoing to assess the safety and efficacy of formoterol as needed in a real-life setting. The results from the Real-Life Effectiveness of Oxis (R) Turbuhaler (R) (RELIEF) study should help to establish the position of formoterol as an effective first-line reliever medication and ultimately le ad to the inclusion of formoterol as needed in treatment guidelines, (C) 20 01 Harcourt Publishers Ltd.