Inhaled steroids are the preferred controller medication for people with uncontrolled asthma. These medications provide better control of asthma symptoms and prevent future asthma attacks better than leukotriene blockers. For those people whose asthma is not well controlled on an inhaled steroid or those with more severe asthma, the combination of an inhaled steroid and a long-acting beta-agonist may be required. This combination therapy appears to be the best medication for these people, which results in the reduction of asthma symptoms, improvement of lung function and the reduction of use of rescue medications.
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Family history is a risk factor for asthma, with many different genes being implicated.  If one identical twin is affected, the probability of the other having the disease is approximately 25%.  By the end of 2005, 25 genes had been associated with asthma in six or more separate populations, including GSTM1 , IL10 , CTLA-4 , SPINK5 , LTC4S , IL4R and ADAM33 , among others.  Many of these genes are related to the immune system or modulating inflammation. Even among this list of genes supported by highly replicated studies, results have not been consistent among all populations tested.  In 2006 over 100 genes were associated with asthma in one genetic association study alone;  more continue to be found.