The most recent update to GINA’s asthma report contains new advice about COVID-19 and asthma, as well as changes to LAMA recommendations

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The Global Initiative for Asthma (GINA) has published an update to its Global strategy for asthma management and prevention for 2022.

The 2022 report includes updated guidance about asthma and COVID-19, with further evidence confirming that patients with well-controlled asthma are not at increased risk of severe COVID-19. Recommendations on aerosol-generating procedures, performing spirometry, and COVID-19 vaccination in people with asthma have all been updated as well.

The guideline development group has also updated its recommendations on long-acting muscarinic agents (LAMAs), emphasising that they should not be used in monotherapy without an inhaled corticosteroid (ICS). The new report further recommends LAMAs as adjuncts to ICS–long-acting bronchodilator inhaler therapy, after a meta-analysis of studies demonstrated that this led to a modest increase in lung function and a modest overall reduction in severe exacerbations.

Other sections have been updated to reflect recent evidence, including sections on the diagnosis of asthma, the assessment of symptom control, the definition of mild asthma, written asthma action plans, and management of acute asthma in healthcare settings.

Asthma is one of the most common chronic lung diseases worldwide, affecting 1–18% of the population in different countries. GINA updates its guidelines regularly to incorporate the latest information from the scientific literature on the diagnoses, management, and prevention of asthma. 

This year, the report was updated on 3 May, World Asthma Day. The World Health Organization first celebrated World Asthma Day in 1998, and it has been organised by GINA since then. The theme of this year’s event is ‘Closing gaps in asthma care’, with an emphasis on the fact that people in different countries and different socioeconomic groups have unequal access to diagnosis and treatment.

In their preface, Drs Helen Reddel and Louis-Phillippe Boulet, Chairs of the GINA Science Committee and Board of Directors respectively, emphasised: ‘The majority of the burden of asthma morbidity and mortality occurs in low- and middle-income countries, and is avoidable. It is clear that if recommendations contained within this report are to improve care of people with asthma, every effort must be made to encourage healthcare leaders to assure availability of, and access to, effective quality-assured medications, and to develop means to implement and evaluate effective asthma management programs.’

They concluded: ‘We hope that you find this report to be a useful resource in the management of asthma and that, in using it, you will recognise the need to individualise the care of each and every asthma patient you see.’

You can find our summary of GINA’s previous report from 2021 here. Additional updates to treatment recommendations and other changes can be found in the full report.

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