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AstraZeneca’s Respiratory & Immunology medical resource centre for healthcare professionals

Discover the latest advances and approaches in asthma, COPD and more

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Are you acting on the most fundamental change in asthma care in over 30 years?

For decades, many asthma treatment guidelines have recommended that patients with mild asthma use a short-acting β2-agonist (SABA) alone as-needed for symptom relief [1]. However, the Global Initiative for Asthma (GINA) changed their treatment recommendations in 2019 after a 12-year campaign to obtain evidence-based strategies for improving the treatment of mild asthma.

Why the change?

Asthma is a variable and fluctuating inflammatory disease that is usually associated with airway inflammation and hyperresponsiveness [2]. SABAs do not treat this underlying inflammation [3].

Patients often use SABA reliever medication to provide quick relief of symptoms, and SABA over-use is common among patients with asthma of all severities [1,3,4]. This is concerning, because over-use of SABAs is associated with poor control and an increased risk of asthma attacks and asthma-related deaths [4].

Did you know?

Using a SABA inhaler three or more times a week is an indicator of increased risk of asthma attacks [1].

Visit the ‘Rate your reliance’ website to find out more about assessing your patients’ reliance on their SABA inhaler.

In comparison, inhaled corticosteroids (ICS) work to reduce airway inflammation in patients with asthma [5]. Regular use of low-dose ICS has been associated with a reduction in asthma-related hospital admissions and deaths [6,7].

Watch Siân Williams, Chief Executive Officer of the International Primary Care Respiratory Group, discuss the treatment of asthma by targeting the underlying inflammation.


[1] Global Initiative for Asthma. Pocket Guide for Asthma Management and Prevention (for adults and children older than 5 years). 2021. Available from: https://ginasthma.org/reports/.

[2] Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention. 2021 GINA Report. Available from: https://ginasthma.org/gina-reports/.

[3] Nwaru BI et al. Eur Respir J. 2020;55:1901872.

[4] Janson C et al. Adv Ther. 2020;37:1124–1135.

[5] Barnes PJ. Pharmaceuticals (Basel). 2010;3:514–540.

[6] Suissa S et al. Thorax. 2002;57:880–884.

[7] Suissa S et al. N Engl J Med. 2000;343:332–336.

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