Nycomed is committed to opening new pathways in the treatment of chronic obstructive respiratory diseases.
Asthma awareness, diagnosis, and proper treatment are key to decreasing the global burden of this disease. One of the ways of accomplishing these goals is through the implementation of treatment guidelines.
Although several countries have such guidelines, many developing nations do not. To address the need for worldwide treatment guidelines in asthma, and to make these available to all nations, the Global Initiative for Asthma (GINA) was implemented to develop a network of individuals, organisations, and public health officials to disseminate information about the care of patients with asthma while at the same time assuring a mechanism to incorporate the results of scientific investigations into asthma care.
The GINA guidelines provide a standard approach to asthma care. Treatment is initiated in a step wise approach according to disease severity. The different asthma severities according to GINA are listed below. Additional information is available at www.ginasthma.com.
GINA Classification of AsthmaSeverity by Clinical Features Before Treatment*
Step
|
Description
|
STEP 1:
Intermittent |
Symptoms less than once a week
Brief exacerbations
Nocturnal symptoms not more than twice a month
- FEV1* or PEF =≥80% predicted
- PEF** or FEV1 variability < 20%
*forced expiratory volume in 1 second
**Peak Expiratory Flow
|
STEP 2:
Mild Persistent |
Symptoms more than once a week but less than once a day
Exacerbations may affect activity and sleep
Nocturnal symptoms more than twice a month
- FEV1 or PEF =≥80% predicted
- PEF or FEV1 variability 20-30%
|
STEP 3:
Moderate Persistent |
Symptoms daily
Exacerbations may affect activity and sleep
Nocturnal symptoms more than once a week
Daily use of inhaled short-acting _2-agonist
- FEV1 or PEF 60-80% predicted
- PEF or FEV1 variability > 30%
|
STEP 4:
Severe Persistent |
Symptoms daily
Frequent exacerbations
Frequent nocturnal asthma symptoms
Limitation of physical activities
- FEV1 or PEF =≤60% predicted
- PEF or FEV1 variability > 30%
| |
*Adapted from Global Initiative for Asthma: Global Strategy for Asthma Management and Prevention. Available as PDF at: www.ginasthma.com