From the Guidelines
The Global Initiative for Asthma (GINA) step 1 asthma therapy recommends short-acting bronchodilators, particularly short-acting inhaled beta 2-agonists, as quick-relief medication for treating symptoms as needed in patients with intermittent asthma. According to the study published in the Journal of Allergy and Clinical Immunology 1, albuterol is the preferred short-acting inhaled beta 2-agonist due to its excellent safety profile and extensive safety data during pregnancy.
Key Points of GINA Step 1 Therapy
- The primary goal is to provide quick relief for symptoms as needed
- Short-acting inhaled beta 2-agonists are the recommended medication
- Albuterol is preferred due to its safety profile and available data ### Administration and Monitoring
- Patients should use their inhaler as needed when symptoms occur, such as wheezing, chest tightness, or shortness of breath
- It is essential for patients to carry their inhaler at all times and seek medical attention if they require frequent use
- Regular follow-up is crucial to assess asthma control and adjust therapy if necessary, typically every 3-6 months.
From the Research
Global Initiative for Asthma (GINA) Step 1 Asthma Therapy
The GINA step 1 asthma therapy recommendations have undergone changes in recent years. According to the latest guidelines, the following points are relevant:
- The GINA recommends that short-acting β2-agonist (SABA) monotherapy should no longer be prescribed for step 1 asthma patients 2.
- As-needed combination inhaled corticosteroids (ICS)-formoterol is the preferred reliever therapy in adults and adolescents with mild asthma 2.
- Symptom-driven or as-needed treatment with ICS-LABA is recommended for step 1 patients, rather than SABA alone 3, 4.
- The main goal of this new approach is to reduce the risk of serious asthma exacerbations and asthma-related deaths in the population of patients with mild asthma 4.
Rationale Behind the Recommendations
The rationale behind these recommendations is based on the risks of SABA monotherapy and the evidence that ICS-formoterol reliever therapy markedly decreases the occurrence of severe asthma exacerbations compared with SABA reliever therapy alone 2.
- There is evidence to suggest that ICS-formoterol reliever therapy has a favorable risk/benefit profile compared with maintenance ICS plus SABA reliever therapy 2.
- Data supporting the use of combination ICS-albuterol reliever therapy in mild asthma are more limited, but there are studies that inform its use in this population 2.
Comparison of Treatment Options
The following treatment options have been compared: