What step of therapy is indicated for a patient diagnosed with asthma and an FEV1 of 58% predicted?

The recommended step of therapy for a patient with asthma and an FEV1 of 58% predicted is to implement a medium-dose inhaled corticosteroid (ICS) combined with formoterol for both maintenance and reliever therapy. This approach is indicated for individuals with moderate to severe asthma characterized by persistent symptoms and limitations in airflow, which is evident from the low FEV1 percentage.

Patients with an FEV1 between 50% and 80% predicted typically present with more significant symptoms, necessitating a more aggressive treatment plan to manage inflammation and improve lung function. The addition of formoterol not only acts as a long-acting bronchodilator for regular maintenance but also provides immediate relief when symptoms arise. This combination therapy can help in reducing exacerbations and provide better control of asthma compared to lower-step therapies.

In this case, the choice of therapy is systematic and aligns with asthma management guidelines, reinforcing the importance of personalizing treatment based on the severity of the disease. Implementing more intensive therapy, such as medium-dose ICS with a long-acting beta-agonist like formoterol, is essential to ensure patients regain control over their asthma and enhance their quality of life.