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Published by Global Initiative for Asthma · Levels of Evidence A, B, C, D
Asthma is a heterogeneous disease, usually characterized by chronic airway inflammation. It imposes a massive global health burden. The GINA Strategy Report provides an evidence-based approach to the diagnosis, assessment, and personalized management of asthma to achieve long-term symptom control, minimize exacerbation risks, and reduce asthma mortality.
Key Takeaways
Key changes in the GINA 2026 Strategy Report include the development of four new flowcharts for the management of acute asthma in primary care and acute care facilities. GINA Track 2 has been updated to include anti-inflammatory reliever (AIR) therapy with combination ICS-SABA at Step 1. New assessment tools, such as the Chronic Airways Assessment Test (CAAT) and the Pediatric Asthma Impairment and Risk Questionnaire (Peds-AIRQ), have been introduced. Additionally, instructions for AIR and MART doses have been simplified, and updated guidance is provided on OCS stewardship, long-acting muscarinic antagonists (LAMAs), and vaccinations (including RSV).
For safety, GINA does not recommend treatment of asthma in adults, adolescents or children 6–11 years with short-acting beta2-agonist (SABA) alone. Instead, they should receive inhaled corticosteroid (ICS)-containing treatment to reduce their risk of severe exacerbations and to control symptoms.
Track 1 (preferred): using low-dose ICS-formoterol as an anti-inflammatory reliever (AIR) is the preferred approach recommended by GINA for adults and adolescents with asthma, because it reduces the risk of severe exacerbations compared with regimens that use SABA as reliever.
Allergen avoidance is not recommended as a general strategy for people with asthma.
Aspirin and NSAIDs are not generally contraindicated in asthma unless there is a history of previous reactions to these agents.
Lung function measurement using spirometry (peak flow if spirometry is not available) is strongly recommended for all patients (except preschool children, or life-threatening presentations) presenting with acute asthma, and again before discharge.
Clinical Topic
Asthma Management and Prevention
Objectives
To reduce asthma prevalence, morbidity, and mortality through an evidence-based asthma management strategy for healthcare providers and policy-makers.
Target Patient Population
Adults, adolescents, and children with asthma.
Diagnostic Criteria
History of typical variable respiratory symptoms (wheeze, shortness of breath, chest tightness, cough) combined with confirmed excessive variability in expiratory lung function (e.g., FEV1 or PEF).
Target Providers
Therapeutic Area
RespiratoryGuideline Scope
Care Settings
Special Populations
System: Levels of Evidence A, B, C, D
Evidence Levels
Contraindications
Monitoring Guidance
Assess asthma symptom control using validated tools (e.g., ACT, ACQ), lung function, exacerbation history, medication side effects, inhaler technique, and adherence. Adjust treatment in a step-wise approach and schedule regular follow-ups (e.g., 1-3 months after starting treatment and within 2-7 days after an exacerbation).
Difficulty
advanced
Learning Paths