The Global Initiative for Asthma (GINA) has published an update to its evidence-based strategy for the management of asthma.

According to GINA, the evidence suggests that relying on regular or frequent use of short-acting bronchodilators (SABAs) for first‑line treatment of asthma is associated with adverse effects. The overuse of SABA inhalers is also associated with adverse clinical outcomes. In contrast, during the 2014 guideline revision GINA did not identify any evidence to support a step 1 SABA‑only recommendation.

Consequently, GINA now recommends that all adults and adolescents starting first-line treatment for asthma should receive symptom-driven or regular low‑dose inhaled corticosteroid controller treatment, which GINA calls a ’population-level risk reduction strategy’, in a similar vein to statins and anti-hypertensives.