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Pocket Guide for Asthma Management and Prevention - For adults and children older than 5 years

Helen Reddel, Louis-Philippe Boulet, Mark Levy,Rebecca Decker,

A Major change in the GINA 2019 Strategy
The 2019 GINA strategy report represents the most important change in asthma mamagement in 30 years.
For safety, GINA no longer recommends treatment with short-acting beta2-agonists (SABA) alone. There is strong evidence that SABA-only treatment, although providing short-term relief of asthma symptoms, does not protect patients from severe exacerbations, and that regular of frequent use of SABAs increases the risk of exacerbations.
GINA now recommends that all adults and adolescents with asthma should receive either symptoms-driven (in mild asthma) or daily low dose ICS-containing controller treatment, to reduce their risk of serious exacerbations.
Details about the new treatment recommendations, and the rationale for the new recommendations about symptom-driven treatment in mild asthma, begin on page 16, with the new treatment figure on page 18. Information about ICS doses is found on page 20.
Why has GINA changed its recommendations for mild asthma?
These new recommendations represent the culmination of a 12-year campaign by GINA to obtain evidence for strategies to improve the treatment of mild asthma. Our aims were:
  • To reduce the risk of serious asthma-related exacerbations and death, including in patients with so-called mild asthma,
  • To provide consistent messaging about the aims of asthma treatment, including prevention of exacerbations, across the whole spectrum of asthma severity.
  • To avoid establishing a pattern of patient reliance on SABA early in the course of the disease.
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