Volume 6 | Issue 9 | 2020 | Respiratory Medicine
Global initiative for asthma (GINA) – What’s new in 2020 AUTHORS: Dr Dermot Nolan, ICGP/HSE Clinical Lead for Asthma; and Dr Emer Glanville, GP Registrar, SE Training Scheme The Global Initiative for Asthma (GINA, https://ginasthma.org) is a medical guidelines organisation which works with public health officials and healthcare professionals globally to reduce asthma prevalence and mortality.
order to reduce the risk of exacerbations and death and also to set out goals of treatment and preventing exacerbations, as well as guidelines on the use and reliance of short-acting beta-agonists (SABA) in early disease.
The 2020 report of the Global Strategy for Asthma Management and Prevention sets out new scientific information about asthma and is a review of the most recent scientific literature by an international panel of experts on the GINA Science Committee.
In 2019, GINA published landmark changes in the management of asthma: ● SABA monotherapy – no longer recommended for Step 1. The background to this change was that frequent use of SABA is associated with adverse clinical outcomes – dispensing of >three canisters per year was associated with increased risk of emergency department presentations
Since 2007, GINA has been actively seeking interventions for mild asthma in
and dispensing of >12 canisters per year was associated with higher risk of death. ● In children under five years, the evidence is still unclear – a trial of ICS should be used in those not responding to as-needed SABA. ● ICS (inhaled corticosteroids) recommended for all adults and adolescents with asthma to reduce risk of serious exacerbations (regular daily treatment or as-required low-dose ICS-formoterol). GINA recommendations on Covid-19 and asthma 2020: ▶ Advise patients to continue taking
FIGURE 1A: GINA 2020 report steps 1-5 in management of adults and adolescents over 12 years
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Figure 1b - GINA 2020 report steps 1-5 in management of Adults and adolescents over 12
