More aggressive treatment needed.

• Position: Asthma treatment

Two years after an expert panel issued guidelines to improve asthma detection and treatment, the disease remains under-recognized and is not being treated aggressively enough, claims William Busse, professor of medicine, University of Wisconsin Medical School, and head of the section of allergy and immunology at UW Hospital and Clinics. "The message that asthma treatment should be more specific and aggressive needs continued emphasis and reinforcement. No longer is symptom treatment ... enough."

The call for more aggressive treatment comes in the wake of a significant increase in the disease, the number of those hospitalized, and the amount of deaths resulting from it. Nationwide, 10-15,000,000 people have asthma, which constricts the lungs' air passages and causes wheezing, coughing, and breathing difficulty.

Two of the most common anti-inflammatory medications are corticosteroids and cromolyn. While corticosteroids traditionally have been used to treat those with severe asthma, expanding their use could reduce moderate, cases of asthma to mild ones, Busse maintains. A major reason anti-inflammatories haven't been used more widely is that only recently has asthma been recognized to be a disease of inflammation, rather than bronchial spasms. By treating the source of the attacks, rather than merely providing relief, doctors and...