The 1997 Winter Meeting of the British Thoracic Society attracted over 1300 delegates and 328 posters and presentations covering every aspect of respiratory disease. This article will highlight selected themes from the meeting.

The widespread adoption of inhaled steroids has transformed the management of asthma, yet the increasing recognition that high dose inhaled steroids carry significant risks of systemic adverse effects is stimulating increased interest in alternative ways of controlling airway inflammation. In a symposium on “New therapies for respiratory disease” Professor Tak Lee summarised the data supporting the use of 5-lipoxygenase inhibitors and leukotriene receptor blockers in asthma. These compounds, which are already on the market in the USA and in some European countries, appear to have significant asthma controlling activity that is complementary to β₂ agonists and may prove useful as steroid sparing agents.

Dexa bone densitometry is highlighting the high incidence of osteopenia and osteoporosis secondary to prolonged or frequent steroid use in asthma1 and such scanning provides a tool for early detection and for monitoring response to treatment. Interpretation of scan results in patients with severe obstructive lung disease is complicated by the effects of immobility and nutritional state on bone density, and further controlled trials in this area are needed.

The origins of asthma in early life form the topic of an ambitious long term environmental intervention study2 3in which an attempt has been made to reduce the early domestic exposure to relevant antigens in a cohort of at-risk infants. Infants are prenatally randomised to allergen avoidance or control groups. These two presentations outlined the evidence to show that it is practicable to control significantly allergen exposure in the home, and the outcome of these interventions is awaited with interest.

The role of corticosteroids remains a focus of therapeutic interest in …