Global Initiative for Asthma Strategy 2021: executive summary and rationale for key changes
The document that ended fifty years of short-acting beta agonist monotherapy. GINA no longer recommends a reliever inhaler alone at any step of asthma treatment: every adult and adolescent should carry an inhaled corticosteroid, either in the reliever itself as budesonide-formoterol taken as needed, or as a daily controller alongside a separate reliever. The reasoning is that a patient who feels better after a puff of salbutamol has treated the symptom and not the inflammation, and that the risk of a severe exacerbation, and of death, tracks reliever use. Track 1, with as-needed budesonide-formoterol, is named the preferred approach because it is the one that reduces severe exacerbations without asking a well-feeling patient to take a daily drug. The register's trials behind that reversal are below.
Esta guía cita 2 de los 35 ensayos de referencia de nuestro registro de Neumología.
As-needed budesonide-formoterol2
- 2018SYGMA 1Neumología · Asma · CSI-formoterol a demandaEn 3.849 pacientes con asma leve, la combinación budesonida-formoterol a demanda redujo las exacerbaciones graves en comparación con terbutalina a demanda.
- 2018SYGMA 2Neumología · Asma · CSI-formoterol a demandaEn 4.215 pacientes con asma leve, la combinación budesonida-formoterol a demanda fue no inferior respecto a las exacerbaciones graves en comparación con budesonida de mantenimiento diaria más terbutalina a demanda.