GINA 2014: Licht und Schatten

Zusammenfassung

Nach acht Jahren hat die Global Initiative for Asthma (GINA) ein umfassendes Update ihrer Empfehlungen vorgelegt. Im Mai 2014 wurde die neue Version online gestellt [www.ginasthma.org] und beim Kongress der European Respiratory Society im September dann offiziell präsentiert. Die Neuerungen beginnen bereits auf Seite 1: GINA ist keine Leitlinie, sondern eine „Global Strategy“. Dies wurde bei der Präsentation auf dem ERS-Kongress in München betont, was den in Richtung des pragmatischen Ansatzes veränderten Anspruch dokumentiert (und möglicherweise die Furcht vor Haftungsfragen).

Abstract

After 8 years the Global Initiative for Asthma (GINA) presented a fully revised report. In May 2014 the new GINA was published online [www.ginasthma.org]. On a live GINA Session at the European Respiratory Society (ERS) conference 2014 in Munich members of the board of directors and of the science committee presented the new contents, e.g. the GINA statement from page one, that GINA is “Not a guideline, but a practical approach to managing asthma in clinical practice” – was explicitly emphasized on the ERS. This may reflect a changing claim towards a more pragmatic attempt (but probably also the fear of liability).

• Literatur

• 1 Chung KF, Wenzel SE, Brozek JL et al. International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma. Eur Respir J 2014; 43: 343-373
• 2 Magadle R, Berar-Yanay N, Weiner P et al. The risk of hospitalization and near-fatal and fatal asthma in relation to the perception of dyspnea. Chest 2002; 121: 329-333
• 3 Silva CM, Barros L. Asthma knowledge, subjective assessment of severity and symptom perception in parents of children with asthma. J Asthma 2013; 50: 1002-1009
• 4 Aaron SD, Vandemheen KL, Boulet LP et al. Overdiagnosis of asthma in obese and nonobese adults. CMAJ 2008; 179: 1121-1131
• 5 Lucas AE, Smeenk FW, Smeele IJ et al. Overtreatment with inhaled corticosteroids and diagnostic problems in primary care patients, an exploratory study. Fam Pract 2008; 25: 86-91
• 6 Montnemery P, Hansson L, Lanke J et al. Accuracy of a first diagnosis of asthma in primary health care. Fam Pract 2002; 19: 365-368
• 7 Marklund B, Tunsater A, Bengtsson C. How often is the diagnosis bronchial asthma correct?. Fam Pract 1999; 16: 112-116
• 8 Travers J, Marsh S, Williams M et al. External validity of randomised controlled trials in asthma: to whom do the results of the trials apply?. Thorax 2007; 62: 219-223
• 9 Guilbert TW, Morgan WJ, Zeiger RS et al. Long-Term Inhaled Corticosteroids in Preschool Children at High Risk for Asthma. N Engl J Med 2006; 354: 1985-1997
• 10 Haahtela T, Jarvinen M, Kava T et al. Effects of reducing or discontinuing inhaled budesonide in patients with mild asthma. N Engl J Med 1994; 331: 700-705
• 11 Boushey HA, Sorkness CA, King TS et al. Daily versus As-Needed Corticosteroids for Mild Persistent Asthma. N Engl J Med 2005; 352: 1519-1528
• 12 Papi A, Canonica GW, Maestrelli P et al. Rescue Use of Beclomethasone and Albuterol in a Single Inhaler for Mild Asthma. N Engl J Med 2007; 356: 2040-2052