2023 GINA report for asthma

The 2023 GINA Global Strategy report was updated with new information and guidance on managing asthma. Some of the key changes include a clarification of terminology for asthma medications (p 56). The previous term, controller, has been substituted where appropriate by maintenance treatment or inhaled corticosteroid (ICS)-containing treatment; maintenance treatment refers to any asthma treatment prescribed for everyday use or use on a regular scheduled basis. The term reliever refers to an asthma inhaler used as-needed for quick relief of symptoms—includes short-acting β-agonists (SABAs) and as needed ICS–formoterol and ICS–SABA. The term anti-inflammatory reliever (AIR) refers to a reliever inhaler containing low-dose ICS plus a rapid-acting bronchodilator (including budesonide–formoterol, beclometasone–formoterol, and ICS–salbutamol). Maintenance and reliever therapy (MART) refers to a treatment regimen in which a patient uses a combination ICS–formoterol inhaler every day as maintenance and also uses the same ICS–formoterol inhaler as-needed for relief of symptoms (only includes combination ICS–formoterol inhalers, such as budesonide–formoterol and beclomethasone–formoterol, not ICS with other long-acting β-agonists [LABAs] or ICS–SABAs). A slide set explaining the new terminology will be published by GINA shortly. “The new terminology—moving away from controller or reliever inhalers to AIR and MART, whilst still using the terms maintenance, and reliever, separately does risk a degree of confusion and will take time to bed in. Previous terminology is so embedded, change will require time and consistent, repetitive messaging”, Dominic E Shaw (Department of Respiratory Medicine, University of Nottingham, Nottingham, UK) commented.