2020 Asthma Guidelines
They Focus On:
1. FeNO (fractional exhaled nitric oxide)
2. Indoor Allergen Mitigation
3. SCIT vs SLIT (subcutaneous vs sublingual routes)
4. Bronchial Thermoplasty
5. Inhaled Corticosteroids for recurrent wheezing
6. Long-acting antimuscarinic agents (LAMA)
- These guidelines are not as wide-ranging as those developed and released in 2007.
- The new recommendations are based on reviews of the scientific literature and the use of the GRADE methodology for assigning a level of certainty (Low, Moderate, or High) for each recommendation.
- Of the six areas, only numbers 2, 3, 5, & 6 have practical implications for primary asthma care.
- The full guidelines: 2020 Focused Updates to the Asthma Management Guidelines:…
Pillow covers and mattress bags to seal in allergens are recommended if you have symptoms. (Moderate Certainty)
Subcutaneous Allergy Shots
SCIT (Subcutaneous Immunotherapy) is recommended for adults and children (>5 yr) with mild to moderate allergic asthma. (Moderate Certainty).
Inhaled Steroids - short course
Children from ages 0-4 yr with recurrent wheezing (3 x /year), triggered by colds and URI’s should have a short course (7-10 days) of inhaled corticosteroid at the onset of a new wheezing episodes (High Certainty).
Single Maintenance Meds
In ages 4+ with moderate to severe-persistent asthma, a combination inhaler containing formoterol and corticosteroid can used as both a daily controller and as a rescue medicine. (Moderate to High Certainty).
Inhaled Steroids Daily
In ages 12 + with mild persistent asthma, inhaled corticosteroids should be used daily, either along with rescue albuterol or in a combination inhaler with albuterol. (Moderate Certainty).
Long Acting Anti-Muscarinic
In age 12 + yr with uncontrolled, persistent asthma, Long Acting Anti-Muscarinic (LAMA) medicine can be added to Inhaled Corticosteroid (ICS) for better control. (Moderate Certainty).