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Update in Asthma Management: A Narrative Review of Recent Advances, Challenges, and Future Directions
1ST5 Respiratory/GIM Registrar, Glenfield Hospital.
Background:
Asthma is a heterogeneous chronic respiratory disease with persistent morbidity and mortality despite effective therapies. The UK continues to report high asthma-related deaths, underscoring the need for improved care.
Objective:
To review recent advances in asthma management, identify ongoing challenges, and outline future directions for clinical practice.
Methods:
This narrative review integrates recent guideline updates (BTS/SIGN 2024, GINA 2024), audit data (NACAP), and emerging evidence on diagnostics, phenotype-driven therapy, and novel treatments.
Findings:
Innovations include biomarker-guided phenotyping, anti-inflammatory reliever (AIR) therapy, biologics targeting Type 2 inflammation, and structured frameworks like A2BCD. Foundational care-such as adherence, inhaler technique, and self-management-remains essential. Systemic improvements, including virtual wards and the BTS Asthma4 bundle, enhance continuity of care. The NHS Green Agenda supports sustainable asthma practices.
Conclusions:
Asthma care is evolving toward personalised, integrated, and environmentally conscious approaches. Clinicians should combine precision therapies with system-level strategies to optimise outcomes.
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