Asthma Control According to GINA 2023: Does Changing the Criteria Improve Asthma Control?

Area of Science:

• Pulmonology
• Clinical Medicine
• Respiratory Health

Background:

• Effective asthma control is crucial for preventing exacerbations and long-term risks.
• Discrepancies in asthma control definitions across clinical guidelines can influence patient management.
• The Global Initiative for Asthma (GINA) guidelines have been updated, necessitating a review of asthma control classifications.

Purpose of the Study:

• To evaluate asthma control patterns using the GINA 2023 criteria.
• To re-classify patients with previously uncontrolled asthma based on the updated GINA 2023 guidelines.
• To assess the impact of revised GINA criteria on asthma control definitions.

Main Methods:

• Analysis of 1299 patients from the COAS study, a cross-sectional multicenter study.
• Patients were initially classified as uncontrolled according to GINA 2010 guidelines.
• Re-classification of patients using the GINA 2023 asthma control criteria.

Main Results:

• A significant portion of previously uncontrolled asthma patients were reclassified as controlled (24.3%) or partially controlled (16.3%) under GINA 2023.
• 59.4% of patients retained their uncontrolled asthma classification.
• Asthma Control Test (ACT) scores, smoking status, allergic rhinitis, and lung function remained consistent post-reclassification.

Conclusions:

• Changes in clinical guideline definitions substantially alter the perception of asthma control.
• Excluding pulmonary function abnormalities in GINA 2023 criteria led to a notable increase in the percentage of controlled asthma patients.
• The updated GINA 2023 guidelines offer a revised perspective on asthma control assessment.