For those who are not specialists in asthma, it may appear that no new therapeutic options have been developed in recent years. Although it is true that the basis of treatment is still the chronic use of inhaled corticosteroids, the molecules we have today are quite different from those that were introduced in the early 1980s.These new drugs have improved compliance, tolerance, and, as a consequence, asthma control. In this context, the impact of the anti-inflammatory effect on the small airways has a decisive role in improving clinical outcomes in asthma. In this issue of Hot Topics in Respiratory Medicine, two experts in the management of asthma, Usmani and Kaplan, provide an overview of the involvement of small airways and the efficacy of ciclesonide in asthma therapy.
There is no doubt that the extended use of inhaled corticosteroids in the treatment of asthma has reduced significantly the morbidity and mortality of this disease. Nowadays, we are in the development stage of new types of corticosteroids that can target the site of inflammation with an enhanced deposition and a reduction in systemic side effects. Again, it may seem that nothing is moving significantly in the field of asthma therapy, but the improvements in the new molecules have provided a better control of this potentially severe disease. I invite you to read this issue of Hot Topics to see evidence of the implication of the small airways in asthma and the advances in its treatment.