What should be included in the treatment for severe persistent asthma?

In the management of severe persistent asthma, high-dose inhaled corticosteroids (ICS) combined with long-acting beta-agonists (LABAs) is a recommended treatment approach. Severe persistent asthma is characterized by frequent symptoms and nighttime awakenings, and patients may experience limitations in daily activities. To effectively control inflammation and improve lung function, higher doses of ICS are necessary.

The inclusion of LABAs plays a crucial role in achieving better symptom control and reducing the risk of exacerbations, providing a synergistic effect when used with high-dose ICS. This combination therapy addresses both the underlying inflammation and the bronchoconstriction associated with asthma, which is essential in this more severe category of the disease.

Other treatment options like a SABA alone would not provide sufficient control, especially in severe cases, since they only offer short-term relief of symptoms without addressing the underlying inflammation. Leukotriene antagonists and oral corticosteroids may be used in certain situations, but they are not primary therapies for managing severe persistent asthma in the same way that high-dose ICS and LABA are. Therefore, the correct combination for maintaining control in patients with severe persistent asthma is high-dose ICS plus LABA.