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Global Initiative for Asthma Strategy 2021. Executive Summary and Rationale for Key Changes.
Helen K Reddel1, Leonard B Bacharier2, Eric D Bateman3
1The Woolcock Institute of Medical Research and The University of Sydney, Sydney, Australia.
Archivos De Bronconeumologia
|March 4, 2022
Summary
The Global Initiative for Asthma (GINA) strategy now advises against short-acting beta2-agonist (SABA) only treatment for asthma. Preferred GINA 2021 guidelines recommend inhaled corticosteroid-formoterol as a reliever for better asthma management.
Area of Science:
- Pulmonology
- Respiratory Medicine
- Clinical Guidelines
Background:
- The Global Initiative for Asthma (GINA) Strategy Report offers annual, evidence-based updates for asthma management.
- Previous guidelines allowed short-acting beta2-agonist (SABA) monotherapy, posing risks of overuse and undertreatment.
Purpose of the Study:
- To summarize key recommendations from the GINA 2021 report.
- To highlight recent changes in asthma management strategies, emphasizing inhaled corticosteroids (ICS).
Main Methods:
- Review of evidence underpinning GINA 2021 recommendations.
- Analysis of large trials comparing ICS-formoterol with SABA alone for mild asthma.
- Examination of updated treatment algorithms for adults, adolescents, and children.
Main Results:
- GINA 2021 discourages SABA-only treatment due to risks and the proven benefits of ICS.
- As-needed ICS-formoterol significantly reduces exacerbations in mild asthma compared to SABA alone.
- New treatment tracks (preferred and alternative) are introduced, with Track 1 favoring ICS-formoterol reliever therapy.
Conclusions:
- Asthma management should shift away from SABA-only approaches.
- The GINA 2021 strategy provides updated, evidence-based pathways for improved asthma control.
- Personalized assessment and management of risk factors remain crucial for all asthma patients.
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