GINA Releases Updated Asthma Guidelines for 2022

The Global Initiative for Asthma (GINA) has updated their guidelines in the 2022 Global Strategy for Asthma Management and Prevention. This current report includes the latest asthma research based on a review of recent scientific literature by an international panel of experts on the GINA Science Committee. 

The key changes to the report include: 

  • GINA methodology. Report compilers have expanded and clarified the description for their research methodology, including relevant GRADE-based reviews. 
  • Guidance about asthma and COVID-19. Further evidence confirms that patients with well-controlled mild to moderate asthma are not at increased risk of severe COVID-19, but the risk is higher in patients requiring oral corticosteroids (OCS) for their asthma and in hospitalized patients with severe asthma. 
  • Asthma diagnosis and management in low- and middle-income countries (LMICs). Low- and middle-income countries shoulder the burden of asthma morbidity. The guide details steps for diagnosis and asthma management in low resource settings. 
  • Assessment of symptom control. Researchers expand details around the rationale for the exclusion of use of as-needed ICS-formoterol >2 or ≤2 times per week from the assessment of symptom control.
  • The definition of mild asthma. After extensive discussion, GINA has adjusted the guidelines on asthma severity. While the current definition of severity is based on ‘difficulty to treat,’ many patients and clinicians often assume that ‘mild asthma’ means no risk and no need for treatment. This assumption can have dangerous consequences, as 30% of asthma deaths occur in people with infrequent symptoms. In the meantime, GINA suggests that the term ‘mild asthma’ should generally be avoided in clinical practice where possible, but if used, it should be qualified with a reminder about the risks of severe exacerbations and the need for ICS-containing treatment. 

Additional changes to the GINA report can be read here

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