TY - T1的哮喘治疗的目标:有多高should we go? JF - European Respiratory Journal JO - Eur Respir J SP - 715 LP - 717 DO - 10.1183/09031936.04.10104904 VL - 24 IS - 5 AU - Reddel, H.K. Y1 - 2004/11/01 UR - //www.qdcxjkg.com/content/24/5/715.abstract N2 - H.K. Reddel is supported by the Ann J. Woolcock Fellowship from the Asthma Foundation of NSW. In the textbook “Respiratory Diseases”, published in 1981, Crofton and Douglas 1 commenced the discussion of asthma management with the comment “It must be admitted that the treatment of asthma is largely palliative”. The chapter provides a bleak picture of high mortality, frequent symptoms,and disabling side-effects of treatment. The use of inhaled corticosteroids (ICS) and, later, long-acting β2-agonists, has produced extraordinary improvements in asthma outcomes, particularly in the burden of disease for patients. More recent attention has focussed on fine-tuning asthma treatment, the aim being to return the patient towards the disease-free state, i.e. not just to improve lung function, which has long been the preferred outcome variable for clinical trials, but to improve the whole spectrum of asthma features, summarised in the expression “asthma control”. These concepts have been addressed by Bateman et al. 2, reporting the results of the Gaining Optimal Asthma controL (GOAL) study. The GOAL study 2 arose from scientific and clinical interest in determining the proportion of asthma patients who could achieve a stringent definition of asthma control. The commercial setting within which this question was examined was a double-blind randomised controlled trial comparing salmeterol and fluticasone combination (SFC) and fluticasone propionate (FP), given b.i.d by Diskus/Accuhaler for 12 months in patients with suboptimally controlled asthma at entry. The GOAL study 2 has raised several interesting issues relating to optimal asthma management, and the way in which response to treatment should be assessed. The GOAL study 2 was planned in the late 1990s, when there was considerable interest in the potential impact of high doses of ICS, with or without long-acting β2-agonists, in achieving better outcomes in asthma. At the time, international asthma … ER -