Acorns and inhalers: the Asthma Clinical Research Network.

摘要

In the early 1970s, the medicine chest for an asthma physician in the United States was quite bare. A few nonspecific inhaled bronchodilators were available, along with theophylline and systemic steroids. Treatment with inhaled steroids was just coming into common use, but many physicians and most patients were either wary of their use or not convinced of their effectiveness. In 1989, when the National Asthma Education and Prevention Program promulgated the first set of treatment guidelines, the good news was that there were many more therapeutic options. The bad news was that the evidence base on how to use these treatments was small and strongly biased because the majority of the clinical data came from studies conducted by manufacturers. The National Asthma Education and Prevention Program guidelines were based mostly on "expert opinion"; what was needed was to expand the evidence base for asthma treatment through rigorous clinical trials.