Can mild asthmatics take preventative medicine only when needed?

I continue to receive some great questions from you guys.  This is one I received a while back.

Your question:  I recently read an article that stated mild asthmatics didn't need to take medication, and that there was no improvement for there lungs to take medication everyday as opposed to when they experienced an asthma flare up. Is this statement true. I have attached the article here... http://www.msnbc.msn.com/id/7490689/ns/health-allergies_and_asthma

My humble answer:  I read that article too, and like you it made me wonder.  Back in the 1980s asthma was treated only during acute attacks, and modern evidence shows that daily treatment with preventative medicines are needed to control asthma.  Personally, I am living proof that a daily dose of steroids in my lungs works, and using steroids only during an attack doesn't work. 

However, I think the key to that article is the words 'mild asthma.'  I believe there were some asthma experts who hypothesized, "Does EVERY asthmatic need daily preventative meds?  Can those with mild asthma get by with using inhaled corticosteroids only during an attack?"  The answer to the study they did obviously leans one to think that those with 'mild asthma' might be able to sneak by without taking daily preventative medicines.  Or, at least this is something worth trialing under the supervision of a physician. 

It actually makes sense.  This study might explain why some asthmatics can go years by not taking any preventative medicines and not have any symptoms.  And it's actually a good thing too, considering the less medicine you can get by with the better. 

Asthma experts have contended for years that if you are on asthma controller medicines and have had no symptoms for years, you should work with your doctor on scaling down your medicine.  If you try and it doesn't work, then you go back on your old medicine regime and leave well enough alone.  So in this regard, the study results are not much of a surprise.

So if you have mild asthma, this is another option for you.  Yet if you have moderate to severe asthma, chances are you'll need to stick with the daily preventative asthma regime that's been taught the past several years.

Other studies continue to confirm (such as this study) what asthma experts over the past several years have noted, that combination therapy works best to control asthma symptoms for those with mild persistent asthma. 

A recent study performed at the University of Arizona of 400 children showed that those taking an inhaled corticosteroid to prevent asthma and Albuterol to treat acute symptoms were 35 percent less likely to have an exacerbation of asthma.  The rate of treatment failure was reduced by 60 percent compared to those taking placebo.

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