Global Initiative for Asthma Strategy 2021 Executive Summary and Rationale for Key Changes

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dc.contributor.authorReddel H.K.
dc.contributor.authorBacharier L.B.
dc.contributor.authorBateman E.D.
dc.contributor.authorBrightling C.E.
dc.contributor.authorBrusselle G.G.
dc.contributor.authorBuhl R.
dc.contributor.authorCruz A.A.
dc.contributor.authorDuijts L.
dc.contributor.authorDrazen J.M.
dc.contributor.authorFitzGerald J.M.
dc.contributor.authorFleming L.J.
dc.contributor.authorInoue H.
dc.contributor.authorKo F.W.
dc.contributor.authorKrishnan J.A.
dc.contributor.authorLevy M.L.
dc.contributor.authorLin J.
dc.contributor.authorMortimer K.
dc.contributor.authorPitrez P.M.
dc.contributor.authorSheikh A.
dc.contributor.authorYorgancioglu A.A.
dc.contributor.authorBoulet L.-P.
dc.date.accessioned2024-07-22T08:05:07Z
dc.date.available2024-07-22T08:05:07Z
dc.date.issued2022
dc.description.abstractThe Global Initiative for Asthma (GINA) Strategy Report provides clinicians with an annually updated evidence-based strategy for asthma management and prevention, which can be adapted for local circumstances (e.g., medication availability). This article summarizes key recommendations from GINA 2021, and the evidence underpinning recent changes. GINA recommends that asthma in adults and adolescents should not be treated solely with short-acting β2-agonist (SABA), because of the risks of SABA-only treatment and SABA overuse, and evidence for benefit of inhaled corticosteroids (ICS). Large trials show that as-needed combination ICS–formoterol reduces severe exacerbations by >60% in mild asthma compared with SABA alone, with similar exacerbation, symptom, lung function, and inflammatory outcomes as daily ICS plus as-needed SABA. Key changes in GINA 2021 include division of the treatment figure for adults and adolescents into two tracks. Track 1 (preferred) has low-dose ICS–formoterol as the reliever at all steps: as needed only in Steps 1–2 (mild asthma), and with daily maintenance ICS–formoterol (maintenance-and-reliever therapy, “MART”) in Steps 3–5. Track 2 (alternative) has as-needed SABA across all steps, plus regular ICS (Step 2) or ICS–long-acting β2-agonist (Steps 3–5). For adults with moderate-to-severe asthma, GINA makes additional recommendations in Step 5 for add-on long-acting muscarinic antagonists and azithromycin, with add-on biologic therapies for severe asthma. For children 6–11 years, new treatment options are added at Steps 3–4. Across all age groups and levels of severity, regular personalized assessment, treatment of modifiable risk factors, self-management education, skills training, appropriate medication adjustment, and review remain essential to optimize asthma outcomes. Copyright © 2022 by the American Thoracic Society
dc.identifier.DOI-ID10.1164/rccm.202109-2205PP
dc.identifier.issn1073449X
dc.identifier.urihttp://akademikarsiv.cbu.edu.tr:4000/handle/123456789/12983
dc.language.isoEnglish
dc.publisherAmerican Thoracic Society
dc.rightsAll Open Access; Hybrid Gold Open Access
dc.subjectAdolescent
dc.subjectAdult
dc.subjectAnti-Asthmatic Agents
dc.subjectAsthma
dc.subjectChild
dc.subjectChild, Preschool
dc.subjectCombined Modality Therapy
dc.subjectDisease Progression
dc.subjectDrug Therapy, Combination
dc.subjectHumans
dc.subjectInfant
dc.subjectPatient Acuity
dc.subjectPractice Guidelines as Topic
dc.subjectRisk Factors
dc.subjectSelf Care
dc.subjectazithromycin
dc.subjectbeta 2 adrenergic receptor stimulating agent
dc.subjectbiological product
dc.subjectcorticosteroid
dc.subjectformoterol
dc.subjectmuscarinic receptor blocking agent
dc.subjectantiasthmatic agent
dc.subjectadd on therapy
dc.subjectArticle
dc.subjectasthma
dc.subjectbiological therapy
dc.subjectchronic obstructive lung disease
dc.subjectclinical assessment
dc.subjectcomorbidity
dc.subjectcoronavirus disease 2019
dc.subjectcorticosteroid therapy
dc.subjectdisease control
dc.subjectdisease exacerbation
dc.subjectdisease severity
dc.subjectdyspnea
dc.subjectemergency care
dc.subjectevidence based practice
dc.subjectfollow up
dc.subjecthealth care planning
dc.subjecthealth care system
dc.subjecthome care
dc.subjecthospital discharge
dc.subjecthuman
dc.subjectinflammation
dc.subjectlow drug dose
dc.subjectlung function
dc.subjectlung function test
dc.subjectmaintenance therapy
dc.subjectminimum effective concentration
dc.subjectpandemic
dc.subjectpatient care
dc.subjectpatient education
dc.subjectpersonalized medicine
dc.subjectprimary medical care
dc.subjectrisk factor
dc.subjectrisk reduction
dc.subjectself care
dc.subjectsevere asthma
dc.subjectwheezing
dc.subjectadolescent
dc.subjectadult
dc.subjectasthma
dc.subjectchild
dc.subjectcombination drug therapy
dc.subjectinfant
dc.subjectmultimodality cancer therapy
dc.subjectpatient acuity
dc.subjectpractice guideline
dc.subjectpreschool child
dc.titleGlobal Initiative for Asthma Strategy 2021 Executive Summary and Rationale for Key Changes
dc.typeArticle

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