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[MIA 2.0, Comprehensive asthma management, guidelines for Mexico].

Désirée E S Larenas-Linnemann1, Jorge A Jorge A2, Arturo Cortés-Telles3

  • 1Centro de Excelencia en Asma y Alergia Larenas, Hospital Médica Sur, Ciudad de México, México.

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Summary

Updated asthma guidelines for Mexico, MIA 2.0, incorporate severe exacerbation management. These evidence-based recommendations ensure current, localized asthma care for patients.

Keywords:
AsmaCrisis asmáticaFracción exhalada de óxido nítricoInmunoterapia con aeroalergenosTratamiento biológicoTriple terapia

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Area of Science:

  • Pulmonology
  • Allergology
  • Clinical Practice Guidelines

Background:

  • The initial Integrated Asthma Management (MIA) guidelines for Mexico were established in 2020, based on international standards.
  • Significant advancements in asthma concepts and treatments have occurred since the initial guideline development.

Purpose of the Study:

  • To develop an updated version of the MIA guidelines, referred to as MIA 2.0.
  • To ensure the new guidelines are strongly evidence-based.
  • To integrate the management of severe asthma exacerbations into the updated guidelines.

Main Methods:

  • The ADAPTE method was employed for the development of MIA 2.0.
  • A multidisciplinary guideline development group, including a core expert team and representatives from 16 institutions, was formed.
  • International guidelines (GINA 2024, GEMA 5.4, BTS/SIGN 2024, Australian Asthma Handbook 2021) were selected as references using AGREE-II criteria.
  • Key clinical questions were formulated across diagnosis, treatment steps 1-4, severe asthma, and exacerbations.
  • A Delphi process was utilized to achieve consensus among the development group.

Main Results:

  • Responses to clinical questions were developed based on evidence from reference guidelines, considering safety, cost, and local applicability in Mexico.
  • The Delphi process facilitated adjustments and consensus-building among the MIA 2.0 development group.
  • The resulting document features figures and algorithms for asthma management, including exacerbation treatment, tailored for Mexico.

Conclusions:

  • MIA 2.0 provides a comprehensive, updated framework for asthma management in Mexico.
  • The guidelines incorporate the latest evidence and address severe asthma exacerbations.
  • The collaborative development ensures the guidelines are relevant and broadly accepted by various medical societies.