Japanese guideline for adult asthma

Ken Ohta, Masao Yamaguchi, Kazuo Akiyama, Mitsuru Adachi, Masakazu Ichinose, Kiyoshi Takahashi, Toshiyuki Nishimuta, Akihiro Morikawa, Sankei Nishima

Research output: Contribution to journalReview articlepeer-review

48 Citations (Scopus)


Adult bronchial asthma (hereinafter, asthma) is characterized by chronic airway inflammation, reversible airway narrowing, and airway hyperresponsiveness. Long-standing asthma induces airway remodeling to cause an intractable asthma. The number of patients with asthma has increased, while the number of patients who die from asthma has decreased (1.7 per 100,000 patients in 2009). The aim of asthma treatment is to enable patients with asthma to lead a healthy life without any symptoms. A partnership between physicians and patients is indispensable for appropriate treatment. Long-term management with agents and elimination of causes and risk factors are fundamental to asthma treatment. Four steps in pharmacotherapy differentiate mild to intensive treatments; each step includes an appropriate daily dose of an inhaled corticosteroid (ICS), varying from low to high doses. Long-acting β2 agonists (LABA), leukotriene receptor antagonists, and theophylline sustainedrelease preparation are recommended as concomitant drugs, while anti-IgE antibody therapy is a new choice for the most severe and persistent asthma. Inhaled β2 agonists, aminophylline, corticosteroids, adrenaline, oxygen therapy, etc., are used as needed against acute exacerbations. Allergic rhinitis, chronic obstructive pulmonary disease (COPD), aspirin induced asthma, pregnancy, and cough variant asthma are also important factors that need to be considered.

Original languageEnglish
Pages (from-to)115-145
Number of pages31
JournalAllergology International
Issue number2
Publication statusPublished - 2011


  • Acute exacerbation
  • Control of asthma
  • Epidemiology of asthma
  • Patient education
  • Treatment step

ASJC Scopus subject areas

  • Immunology and Allergy


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