ArticleLung India : official organ of Indian Chest Society
The global initiative for asthma guidelines (2019): change in the recommendation for the management of mild asthma based on the SYGMA-2 trial - A critical appraisal.
Article in Lung India : official organ of Indian Chest Society. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 28 citations in OpenAlex.
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- Frequency of Severe Asthma and Its Clinical Phenotypes at the Asthma Clinic in One of the Largest Sudanese Tertiary Pediatric Hospitals: A Cross-Sectional Hospital-Outpatient-Based Study.Journal of asthma and allergy · 2024Article
- Psychological distress and associated factors among asthmatic patients in Southern, Ethiopia, 2021.Asthma research and practice · 2023Article
- The Changing Asthma Management Landscape and Need for Appropriate SABA Prescription.Advances in therapy · 2023Article
- MiR-493-5p inhibits Th9 cell differentiation in allergic asthma by targeting FOXO1.Respiratory research · 2022Article
- Expert Opinion on Practice Patterns in Mild Asthma After the GINA 2019 Updates: A Major Shift in Treatment Paradigms from a Long-Standing SABA-Only Approach to a Risk Reduction-Based Strategy with the Use of Symptom-Driven (As-Needed) Low-Dose ICS/LABA.Current allergy and asthma reports · 2022Review
- Severe asthma in children: An official statement from Saudi Pediatric Pulmonology Association.Saudi medical journal · 2022Article
- Keeping Pace with Adolescent Asthma: A Practical Approach to Optimizing Care.Pulmonary therapy · 2022Article
- A randomized, double-blind, placebo-controlled phase I trial of inhalation treatment of recombinant TFF2-IFN protein: A multifunctional candidate for the treatment of COVID-19.Frontiers in pharmacology · 2022Article
- Pharmacology Versus Convenience: A Benefit/Risk Analysis of Regular Maintenance Versus Infrequent or As-Needed Inhaled Corticosteroid Use in Mild Asthma.Advances in therapy · 2022Article
- LncRNATUG1 Facilitates Th2 Cell Differentiation by Targeting the miR-29c/B7-H3 Axis on Macrophages.Frontiers in immunology · 2021Article
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Authors and funding
4 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
The Global Initiative for Asthma (GINA) recently released their updated Global Strategy for Asthma Management and Prevention Guide (2019). The pocket guide for practicing clinicians states that "the 2019 GINA strategy report represents the most important change in asthma management in 30 years." An important recommendation is the change in treatment strategy for the management of mild asthma where the guideline recommends that" all adults and adolescents with asthma should receive either symptom driven (in mild asthma) or daily low dose inhaled corticosteroid (ICS) containing controller treatment to reduce the risk of serious exacerbations." Our study critically appraises the SYGMA-2 trial, a key trial that largely formed the basis of this recommendation and discusses the potential consequences of using only long-acting beta-2-agonist + ICS as needed as against regular, daily low-dose ICS with as-needed short-acting beta-2-agonist. Our critique covers airway inflammation, disease heterogeneity, understanding the noninferiority margin and its consequences, the Hawthorne effect, and conflict of interest. It is our view that statement of this magnitude will have far-reaching implications for clinical practice which will be in the interests of some patients but also against the interests of others.
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