Asthma Clinical Practice Guidelines (GINA, 2019)

Global Initiative for Asthma (GINA)

This is a quick summary of the guidelines without analysis or commentary. For more information, go directly to the guidelines by clicking the link in the reference.

November 04, 2019

Guidelines for the management and prevention of asthma were published in 2019 by the Global Initiative for Asthma (GINA).[1]

For safety reasons, treatment with short-acting beta2-agonists (SABA) only is no longer recommended.

To reduce risk of serious exacerbations and to control symptoms, all adults and adolescents with asthma should receive controller treatment containing inhaled corticosteroids (ICS).

For mild asthma, as-needed low-dose ICS and low-dose formoterol are recommended. If formoterol is not available, the patient should take low-dose ICS whenever SABA is taken.

ICS-containing treatment should be initiated as soon as possible after asthma diagnosis.

Asthma medications should be added or deleted as the frequency and severity of the patient's symptoms change, as follows:

  • Step 1: As-needed low-dose ICS-formoterol

  • Step 2: Daily low-dose ICS plus as-needed SABA, or as-needed low-dose ICS-formoterol

  • Step 3: Low-dose ICS-LABA maintenance plus as-needed SABA, or low-dose ICS-formoterol maintenance and reliever therapy

  • Step 4: Low-dose ICS-formoterol as maintenance and reliever therapy, or medium-dose ICS-LABA maintenance plus as-needed SABA

  • Step 5: Refer for expert investigation and add-on treatment

For more Clinical Practice Guidelines, go to Guidelines.

For more information, go to Asthma.

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