Asthma Knowledge Centre
Asthma Treatment
Pharmacological - Treatment steps for achieving control
A patient’s level of asthma control at presentation, as well as their current treatment, if any, should determine how the patient should be further treated. This approach, outlined in the revised GINA 2007 guidelines, focuses on the achievement of control as the basic objective, noting that control is not static, and patients must be monitored continuously to maintain control (Figure 1).1
"For example, if asthma is not controlled on the current treatment regimen, treatment should be stepped-up until control is achieved. If control has been maintained for at least three months, treatment can be stepped down, with the aim of establishing the lowest step and dose of treatment that maintains control…” (GINA 2007 guidelines).1
Figure 1. Management approach based on control (for children older than 5 years, adolescents and adults)1
* ICS=inhaled glucocorticosteroids
**=Receptor antagonist or synthesis inhibitors
***Preferred controller options are shown in shaded boxes
Alternative reliever treatments include inhaled anticholinergics, short-acting oral ß2-agonists, some long-acting ß2-agonists, and short-acting theophylline. Regular dosing with short and long-acting ß2-agonist is not advised unless accompanied by regular use of an inhaled glucocorticosteroid.
[Reproduced with permission from the Global Initiative for Asthma (GINA) Report 2007; available at: www.ginasthma.com. Copyright GINA 2007. ICS=inhaled corticosteroid; IgE=immunoglobin E]
References:
1. GINA. Global Initiative for Asthma. www.ginasthma.com. 2007.