Global Initiative for Asthma Strategy 2021. Executive Summary and Rationale for Key Changes; [Estrategia Global para el Manejo del Asma 2021. Resumen ejecutivo y razones de los cambios clave]

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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.accessioned2024-07-22T08:05:08Z
dc.date.available2024-07-22T08:05:08Z
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. © 2021 American Thoracic Society
dc.identifier.DOI-ID10.1016/j.arbres.2021.10.003
dc.identifier.issn03002896
dc.identifier.urihttp://akademikarsiv.cbu.edu.tr:4000/handle/123456789/12994
dc.language.isoEnglish
dc.publisherSociedad Espanola de Neumologia y Cirugia Toracica (SEPAR)
dc.rightsAll Open Access; Hybrid Gold Open Access
dc.subjectallergen
dc.subjectantibiotic agent
dc.subjectazithromycin
dc.subjectbeta 2 adrenergic receptor stimulating agent
dc.subjectbiological product
dc.subjectcigarette smoke
dc.subjectcorticosteroid
dc.subjectdexamethasone
dc.subjectformoterol
dc.subjectmuscarinic receptor blocking agent
dc.subjectparacetamol
dc.subjectprednisolone
dc.subjectprednisone
dc.subjectvitamin D
dc.subjectadd on therapy
dc.subjectage
dc.subjectasthma
dc.subjectavoidance behavior
dc.subjectbreast feeding
dc.subjectdisease exacerbation
dc.subjectdisease severity
dc.subjectdrug use
dc.subjectenvironmental exposure
dc.subjectevidence based medicine
dc.subjectfollow up
dc.subjecthealth care availability
dc.subjecthuman
dc.subjectinformation dissemination
dc.subjectlow drug dose
dc.subjectlung function
dc.subjectmedical assessment
dc.subjectmedical decision making
dc.subjectmedical research
dc.subjectpatient care
dc.subjectpatient education
dc.subjectpractice guideline
dc.subjectpregnancy
dc.subjectrisk assessment
dc.subjectrisk management
dc.subjectself care
dc.subjectShort Survey
dc.subjectsymptom
dc.subjecttreatment outcome
dc.subjecttreatment planning
dc.subjectvitamin D deficiency
dc.titleGlobal Initiative for Asthma Strategy 2021. Executive Summary and Rationale for Key Changes; [Estrategia Global para el Manejo del Asma 2021. Resumen ejecutivo y razones de los cambios clave]
dc.typeShort survey

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