USE Y·DO OTCGn INTRODUCTION Treatment of asthma: From the child to the adult 4A A sth ma is One Of themOSt COllll11011 respiratory ai[me nlS in in dus tri a li zed COU ntries and_ Still res ults in . unacceptable morh1d1ty and mortality rates. O ur und ersta ndrng of the 111ccha111s ms of- devclo pmc111 ol asthma has increased si g nificantly in the past few years and. as a result. it s management has chan ge d progress ive ly. Many conse nsus statements providin g treat ment guid elines have bee n pub li s hed for both adult and child hoo d asthma. Usua lly. the ped iat ric and ad ult aspects of asth ma m an a geme nt have bee n considered separat e ly. I-lowewr . we now realize that the physi opallwlogy of asth ma is quite ~imilar in ch ildren and adults an d that thL' approach to tre atment should be base d on simi lar g rounds. w ith an e mphas is on e nvironm en tal control and early trea tment of airway infla mmati o n. At a symposium in Mo ntreal, Quebec on Dece mbe r 4, l 993. represen tat ives of the ped iatric and adult mi lieux gathered under the auspices of the Que bec T horacic Soc iety, the Quebec As thma Edu catio n Net work and the Univers ity of Mon treal C ontinuin g Me dical Ed ucation Bu rea u to discuss a longitudinal ap proach to asthma treatme nt in adults and children. Reporting from this last symposium and taking into account rec en tl y published studi es , the contributors tn this sup plemen t revi w man y cr iti ca l issues in asthma trea tme nt an d try to ans wer su ch ques tions as: Do asthmatic child ren become asth ma ti c adu lts and, if so. can we prevent this? Is the sugges ted role of inhaled corticosteroids as first-line drugs in asth m::i ju st ifi e d? Can cortico steroids lead to as thma r em i ssio n in children or adults'? Is th ere still a pl ace fo r nonste roidal bronchial anti -i nflammat or y agents or theo phylline? Is reg ular use of beta2-agonists really detr imen tal'! How sh ould we use long-a ctin g beta2-agonists' 1 S hould we pro vide asthma educa tion and act i on plans to all asthm atic pat ient and. if so , how and whe n? Should pati ents m easure their peak expi ratory flow rates reg ularly'! Wh at will be t he main de ve lo pme nts in as thm a treatmen t over the next few years? Is it possible to see any c ure coming for asth ma? Wha t is the ·Que bec Asth ma Ed uc at ion Ne twork '? The co ntributors to this suppll'mcnt do not wan t to du plicat established asth ma treatm L·nt g ui de lines. but wish to provide further disc ussion arou nd the c on trovers i es in curren t asthma trea tmen t. We hope that it wil l prove useful to t hose who hav e to make da y-to-day th erapeut ic dec isions in ch ildren or adults pres en ting with a thrna, and be a sourcl' of stimulation to t hose searchi ng for new approac hes and trea tme nts aimed at red ucing the s ti ll exc essive morbidity associ ated with this disease . We wish to thank those pharmaceuti cal c ompan ies wlm gene rously sup ported the symposi um. and Astr a and G la xo for the sponso rship nf this proc eedings. Louis-Philippe Boulet MO Centre de Pneumologie de l'H6pital Laval Sainte-Foy, Quebec Robert Thivierge MD H6pital Sainte-Justine Montreal. Quebec Can Respir J Vol 2 Suppl A March 1995