Asthma -- von der Diagnose zur erfolgreichen Therapie.

Background* In Germany, 5 % of the population is suffering from Asthma which is, alongside COPD, the most common chronic respiratory disease encountered in family medicine and the most common chronic disease in pediatric practice. Search methods This continuing educational article is based on the National Disease Guideline for Asthma and the addendum of 2020, which are supplemented by findings from special investigations and past publications by the author who is an expert for respiratory diseases working in family medicine. Key messages Based on a careful medical history and considering a thoughtful differential diagnosis, the diagnosis for asthma can be established in a relatively safe manner and confirmed by pulmonary function testing including a bronchodilator test. Alternatively, and in exceptional cases, peak-flow measurement and/or the measuring of exhaled nitrogen oxide can be helpful. First and foremost, the therapy consists of an inhalation of a corticosteroid taken alone or in combination with a long-acting betaagonist. This anti-inflammatory therapy is able to prevent a remodeling, i.e., the destruction of the mucous membrane, a thickening of the basal membrane or a hypertrophy of the bronchial muscles and the development of a functional obstruction. In case of an insufficient effect, long-acting muscarinic antagonists or leukotriene antagonists can be added; also, if necessary, biologicals can be contemplated. A long-term treatment with oral corticosteroids should be avoided, if possible. Conclusions Given an early diagnosis and correct treatment, the vast majority of asthmatics can lead a life without symptoms or, at worst, experience temporary mild symptoms. A prerequisite is a sufficiently assessed anti-inflammatory therapy, which must be regularly adapted to the current severity and which the patient carries out regularly and correctly. [ABSTRACT FROM AUTHOR]