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

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.