The Global Initiative for Asthma 2019 recommendation for mild asthma – A critique

South African Family Practice

 
 
Field Value
 
Title The Global Initiative for Asthma 2019 recommendation for mild asthma – A critique
 
Creator Irusen, Elvis M.
 
Subject — GINA 2019; mild asthma; regular ICS + LABA combination; critique
Description Recognising that mild asthmatics are at risk of exacerbations and mortality, the Global Initiative for Asthma (GINA) issued an updated strategy in 2019. This was premised on two studies culminating in their recommendation that mild asthma should be treated by using a combination of a rapid and long-acting beta 2 agonist and an inhaled corticosteroid (ICS) administered as required. Their rationale is, however, debatable, as the studies actually showed that regular daily ICS administration was more effective for a number of asthma control endpoints. A patient-driven treatment strategy is also questionable, as there are a number of concerns about behaviour of patients suffering from asthma and perception of airway narrowing that should trigger medication intake but in fact does not do so. These deficiencies also influence a similar maintenance and reliever treatment (MART) approach that would be suboptimal. Intermittent ICS regimens are also inferior when compared to regular treatment. Not all asthmatics respond to the same dose of ICS. The best way to manage asthma is by adopting a step-up ICS approach, to encompass varying disease severity, with a long-acting beta agonist taken on a daily basis, ideally in a single combination inhaler.
 
Publisher AOSIS
 
Contributor
Date 2020-03-05
 
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — —
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/safp.v62i1.5104
 
Source South African Family Practice; Vol 62, No 1 (2020): Part 2; 4 pages 2078-6204 2078-6190
 
Language eng
 
Relation
The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:

https://safpj.co.za/index.php/safpj/article/view/5104/6053 https://safpj.co.za/index.php/safpj/article/view/5104/6052 https://safpj.co.za/index.php/safpj/article/view/5104/6054 https://safpj.co.za/index.php/safpj/article/view/5104/6051
 
Coverage — — —
Rights Copyright (c) 2020 Elvis M. Irusen https://creativecommons.org/licenses/by/4.0
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