[New perspectives in GINA Asthma Guideline 2006]

The GINA (Global Initiative for Asthma) 2006 guideline contains far-reaching innovations in asthma management and control. The dose and choice of recommended medication depend on the degree of asthma severity and the quality of asthma control, rather than using the known stepwise severity approach. This flexible scheme gives the treating physician great freedom in the choice of substance used. However, the coexistence of the nonetheless valid four-degree severity grading with the new five-degree therapy scheme may cause confusion. The asthma control-guided new treatment recommendations are based on the experience with the GOAL (Gaining Optimal Asthma controL) trial. Altogether, the GINA 2006 guideline represents a shift of paradigm in asthma management. The efficacy of these recommendations and their practicability, however, have still to be proven. The aim of this review is, first, to introduce these new aspects and, second, to critically discuss advantages and potential disadvantages.