ABSTRACT
Most patients with persistent asthma can be well controlled with minimal
toxicity employing strategies that include avoidance of clinically relevant allergens, pharmacotherapy, allergen immunotherapy in selected patients,
and control of comorbid conditions such as rhinosinusitis and gastroeso-
phageal reflux that can otherwise negatively impact asthma. Nonetheless,
even with the broadening repertoire of agents now approved as asthma
treatments (inhaled and systemic corticosteroids, leukotriene modifiers,
cromolyn, nedocromil, b-agonists, methylxanthines, and omalizumab), and increasing use of regimens that combine several agents that have com-
plementary mechanisms, there remains a subset of patients who either do not respond adequately to available agents or develop significant toxicities
to them. Consequently, there is still an important need for additional phar-
macologic agents for asthma. In addition to the development of new thera-
pies, there are alternate agents that are currently available for human use, that
have undergone at least some clinical trials for asthma, but are approved for
indications or uses other than for asthma, such as rheumatologic disease
or suppression of transplant rejection. Generally, these available alternate agents have known immunosuppressive or other immune-modulating effects
that, at least in concept, might benefit the inflammatory basis of asthma.
Specifically, these agents include gold, methotrexate, azathioprine, hydroxy-
chloroquine, dapsone, nebulized lidocaine, inhaled furosemide, cyclosporine,
intravenous immunoglobulin, and troleandomycin (1-4).
