Japanese guideline for Adult Asthma 2014

Ken Ohta, Masakazu Ichinose, Hiroyuki Nagase, Masao Yamaguchi, Hisatoshi Sugiura, Yuji Tohda, Kohei Yamauchi, Mitsuru Adachi, Kazuo Akiyama

Research output: Contribution to journalReview articlepeer-review

52 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 intractable asthma. The number of patients with asthma has increased, and that of patients who die from asthma has decreased (1.5 per 100,000 patients in 2012). The aim of asthma treatment is to enable patients with asthma to lead a normal life without any symptoms. A good relationship between physicians and patients is indispensable for appropriate treatment. Long-term management with antiasthmatic agents and elimination of the causes and risk factors of asthma are fundamental to its treatment. Four steps in pharmacotherapy differentiate between mild and intensive treatments; each step includes an appropriate daily dose of an inhaled corticosteroid, varying from low to high. Long-acting β2-agonists, leukotriene receptor antagonists, and sustained-release theophylline are recommended as concomitant drugs, while anti-immunoglobulin E antibody therapy has been recently developed for the most severe and persistent asthma involving allergic reactions. Inhaled β2-agonists, aminophylline, corticosteroids, adrenaline, oxygen therapy, and others are used as needed in acute exacerbations by choosing treatment steps for asthma exacerbations depending on the severity of attacks. Allergic rhinitis, chronic obstructive pulmonary disease, aspirin-induced asthma, pregnancy, asthma in athletes, and coughvariant asthma are also important issues that need to be considered.

Original languageEnglish
Pages (from-to)293-333
Number of pages41
JournalAllergology International
Issue number3
Publication statusPublished - 2014 Sep 11


  • Diagnosis of adult asthma
  • Epidemiology of asthma
  • Long-term management
  • Management of acute exacerbations
  • specific considerations

ASJC Scopus subject areas

  • Immunology and Allergy


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