Understanding the Updates in the Asthma Guidelines

Semin Respir Crit Care Med. 2022 Oct;43(5):595-612. doi: 10.1055/s-0042-1745747. Epub 2022 Jun 21.

Abstract

Asthma is a chronic inflammatory lung disease that affects millions of Americans, with variable symptoms of bronchospasm and obstruction among individuals over time. The National Heart, Lung, and Blood Institute (NHLBI) published the 2020 Focused Updates to the Asthma Management Guidelines based on the latest research since the 2007 Expert Panel Report-3 (EPR-3). The following article reviews the 21 new recommendations on the six core topics in asthma: use of intermittent inhaled corticosteroids, long-acting muscarinic antagonist therapy, use of the fractional exhaled nitric oxide test in asthma diagnosis and monitoring, indoor allergen mitigation, immunotherapy, and bronchial thermoplasty. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to rate recommendations as strong or conditional based on the evidence. The recommendations were based on systematic reviews of the literature and focused on patient-centered critical outcomes of asthma exacerbations, asthma control, and asthma-related quality of life. Understanding the recommendations with consideration of individual values through shared decision-making may improve asthma outcomes.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Allergens
  • Anti-Asthmatic Agents* / therapeutic use
  • Asthma* / drug therapy
  • Asthma* / therapy
  • Humans
  • Muscarinic Antagonists / therapeutic use
  • Quality of Life

Substances

  • Adrenal Cortex Hormones
  • Allergens
  • Anti-Asthmatic Agents
  • Muscarinic Antagonists