Global Initiative for Asthma
Global Strategy for Asthma Management and Prevention
This guideline holds 5 recommendations and 1,033 references.
Summary
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
SABA-only treatment is no longer recommended; ICS-containing treatment is essential to reduce the risk of severe exacerbations and death.
GINA Track 1 with low-dose ICS-formoterol as an anti-inflammatory reliever (AIR) is the preferred treatment approach for adults and adolescents.
GINA Track 2 now includes anti-inflammatory reliever (AIR) therapy with combination ICS-SABA added at Step 1.
Confirmation of the asthma diagnosis through objective lung function testing is critical to avoid over- or under-treatment.
Asthma control involves assessing both recent symptom control and the future risk of adverse outcomes like exacerbations.
Difficult-to-treat and severe asthma require systematic evaluation of inhaler technique, adherence, comorbidities, and phenotypic markers before stepping up to biologic therapies.
OCS stewardship is prioritized to minimize the short-term and long-term adverse effects of oral corticosteroids.
What is new in this version
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).
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