🌬️ Asthma GINA Stepwise Treatment
This tool maps asthma symptom burden to a GINA treatment step (1–5) and gives the preferred Track 1 (ICS-formoterol reliever) and alternative Track 2 regimens.
Before stepping up, inhaler technique, adherence, and triggers are checked, and step-down after ≥ 3 months of control never stops ICS entirely. (original synthesis · not guideline verbatim)
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When to use
Use to select the controller/reliever regimen at each step, anchored on the principle that adults/adolescents always include ICS and never use SABA alone.
How it works
Symptom level → step 1–5. Track 1: as-needed low-dose ICS-formoterol (steps 1–2) → MART (step 3) → medium MART (step 4) → specialist + LAMA/biologics (step 5). Track 2 uses SABA/ICS-SABA reliever with daily ICS.
Key points
- Before stepping up, inhaler technique, adherence, and triggers are checked, and step-down after ≥ 3 months of control never stops ICS entirely. (original synthesis · not guideline verbatim)
- Track 1 uses ICS-formoterol as both maintenance and reliever (MART) from step 3, reducing exacerbations.
- Step 5 prompts phenotyping and biologic therapy in specialist care.
References
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Symptom/control level | Symptoms ≤ 2 days/week, normal lung function |
|---|---|
| Reliever track | Track 1 (preferred · ICS-formoterol reliever) |
→GINA stepStep 1
- Preferred regimen：As-needed low-dose ICS-formoterol (AIR, no daily maintenance needed)
- Reliever：Low-dose ICS-formoterol (as needed)
- General rule：Adults/adolescents should all include ICS, never SABA alone; before stepping up, check inhaler technique/adherence/triggers
| Symptom/control level | Uncontrolled on the above treatment or severe asthma |
|---|---|
| Reliever track | Track 2 (SABA/ICS-SABA reliever) |
→GINA stepStep 5
- Preferred regimen：Refer to respiratory specialist for phenotyping; add LAMA, consider biologics; high-dose ICS-LABA if needed
- Reliever：SABA or ICS-SABA (as needed)
- General rule：Adults/adolescents should all include ICS, never SABA alone; before stepping up, check inhaler technique/adherence/triggers
Frequently asked questions
- What is Asthma GINA Stepwise Treatment?
- This tool maps asthma symptom burden to a GINA treatment step (1–5) and gives the preferred Track 1 (ICS-formoterol reliever) and alternative Track 2 regimens.
- How is Asthma GINA Stepwise Treatment calculated? What is the core formula?
- Symptom level → step 1–5. Track 1: as-needed low-dose ICS-formoterol (steps 1–2) → MART (step 3) → medium MART (step 4) → specialist + LAMA/biologics (step 5). Track 2 uses SABA/ICS-SABA reliever with daily ICS.
- When is Asthma GINA Stepwise Treatment used?
- Use to select the controller/reliever regimen at each step, anchored on the principle that adults/adolescents always include ICS and never use SABA alone.
- What are the key clinical points for Asthma GINA Stepwise Treatment?
- Before stepping up, inhaler technique, adherence, and triggers are checked, and step-down after ≥ 3 months of control never stops ICS entirely. (original synthesis · not guideline verbatim) Track 1 uses ICS-formoterol as both maintenance and reliever (MART) from step 3, reducing exacerbations. Step 5 prompts phenotyping and biologic therapy in specialist care.
- What are the limits and cautions when using Asthma GINA Stepwise Treatment?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- How is Asthma GINA Stepwise Treatment calculated in practice? Can you show a worked example?
- Inputs: Symptom/control level Symptoms ≤ 2 days/week, normal lung function, Reliever track Track 1 (preferred · ICS-formoterol reliever) → Result: GINA step Step 1（Preferred regimen: As-needed low-dose ICS-formoterol (AIR, no daily maintenance needed), Reliever: Low-dose ICS-formoterol (as needed), General rule: Adults/adolescents should all include ICS, never SABA alone; before stepping up, check inhaler technique/adherence/triggers） Inputs: Symptom/control level Uncontrolled on the above treatment or severe asthma, Reliever track Track 2 (SABA/ICS-SABA reliever) → Result: GINA step Step 5（Preferred regimen: Refer to respiratory specialist for phenotyping; add LAMA, consider biologics; high-dose ICS-LABA if needed, Reliever: SABA or ICS-SABA (as needed), General rule: Adults/adolescents should all include ICS, never SABA alone; before stepping up, check inhaler technique/adherence/triggers）