Trends in pharmacological sciences
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Current therapy for asthma with inhaled corticosteroids and long-acting inhaled beta(2)-agonists is highly effective, safe and relatively inexpensive, but for many patients, their disease remains poorly controlled. Most advances in asthma therapy have occurred through improving these drug classes, and a major developmental hurdle is to improve existing drug classes. The major unmet needs include better treatment of severe asthma, and curative therapies for mild to moderate asthma. ⋯ New treatments targeting the underlying allergic/immune process would treat concomitant allergic diseases. Improved immunotherapy approaches have the prospect of disease modification, although prospects for a cure are currently remote. The most promising therapeutic developments for asthma are discussed in this review.
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Despite intensive research, genetics-based personalized pain therapy has yet to emerge. Monogenetic heredity seems to be restricted to very rare and extreme phenotypes, whereas common phenotypes are very complex and multigenetic. ⋯ However, genetics has some potential practical uses: CYP2D6, MC1R and potentially PTGS2 could provide guidance on the right choice of analgesics. After more than a decade of identifying genetic associations, the current challenge is to intensify compilation of this information for precisely defined clinical settings for which improved pain treatment is possible.