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Press release
Thursday 3 December 2020
Updates to six key areas of asthma care focus on improving diagnosis, management and treatment.
The National Institutes of Health today announced 19 recommendations in six key areas of asthma diagnosis, management and treatment. The new guide, published in the Journal of Allergy and Clinical Immunology, represents the first updates to comprehensive federal asthma care and treatment guidelines in over a decade, and focuses on treatment interventions tailored to specific age groups based on severity of the disease using inhaled corticosteroids, long-acting antimuscarinic antagonists, immunotherapy, alleviation of allergens inside, fractional expired nitric oxide test and bronchial thermoplasty. The recommendations are based on systematic reviews conducted by the Agency for Healthcare Research and Quality and on contributions from participating organizations to the National Asthma Education Program (NAEPP), medical experts and the public. .
The National Heart, Lung, and Blood Institute (NHLBI), part of NIH, coordinates the NAEPP Coordinating Committee (NAEPPCC) and the 19-member expert working group that developed the 2020 Focused Updates to the Asthma Management Guidelines: A Report from The National Asthma Education and Prevention Program Expert Panel Working Group.
“NHLBI’s goal is to ensure that care for all people with asthma is optimal, equitable, and based on the best available evidence,” said NHLBI Director Gary H. Gibbons, MD. “These updated guidelines are intended to support decision-making between patients and their providers, so people with this chronic disease can lead full and active lives. “
Asthma affects the airways of the lungs, causing them to narrow and interfere with breathing. According to the Centers for Disease Control and Prevention, approximately 25 million people in the United States have it, including 5.5 million children. Without proper treatment, asthma can severely restrict activities and lead to flare-ups that can lead to hospitalization or death.
“The last national guide to asthma care was published 13 years ago, and since then we have made substantial progress in understanding how to treat asthma in children and adults,” said Michelle M. Cloutier, MD, professor emeritus, UCONN School of Medicine, and chair of the NAEPPCC Expert Group Working Group. “In addition to the management of asthma varying according to the age group and the severity of the disease, the preferences and values that people with asthma place on different therapies must be taken into account. The new guidelines reflect some of these new approaches. “
The targeted updates provide new direction for six areas:
- Use of inhaled corticosteroids when needed for recurrent wheezing or persistent asthma.
- Use of long-acting antimuscarinic antagonists (LAMAs) with inhaled corticosteroids for the long-term management of asthma. LAMA is a bronchodilator, a medicine that helps relax muscles in the airways.
- Use allergy shots containing very small amounts of the allergen to treat some people with allergic asthma.
- Use one or more methods to reduce exposure to indoor asthma triggers.
- Using a fractional exhaled nitric oxide test to help manage asthma or help confirm a diagnosis in certain patients when the diagnosis is unclear. This test involves breathing through a tube connected to a machine that measures the amount of nitric oxide, which can increase with inflammation of the airways.
- Use of bronchial thermoplasty to treat selected adults with persistent asthma. During this procedure, heat is used to shrink the muscle around the airways.
Several new features aim to help healthcare providers and clinicians successfully engage with their patients and families to put the recommendations into practice. For example, the sections on implementation tips provide detailed summaries of recommendations to help clinicians quickly; indicate to whom the guidelines apply; demonstrate how to use it in patient care and list issues to discuss with patients and families. The treatment step charts for asthma management have also been updated.
Additional resources for health care providers, including 2020 Targeted Updates to Asthma Management Guidelines Clinician’s Guides and At-a-Glance Guides (with updated step-by-step tables), updated topic fact sheets and FAQs, are available at www.nhlbi.nih.gov/ asthmagidelines. In addition to these resources for clinicians, educational resources for patients and caregivers are also available through the NHLBI. Learn more Breathe betterSM program at www.nhlbi.nih.gov/BreatheBetter.
About the National Heart, Lung, and Blood Institute (NHLBI): NHLBI is the world leader in conducting and supporting heart, lung and blood disease and sleep disorders research that advances scientific knowledge, improves public health and saves lives. For more information visit www.nhlbi.nih.gov.
About the National Institutes of Health (NIH):NIH, the nation’s medical research agency, comprises 27 institutes and centers and is a component of the US Department of Health and Human Services. The NIH is the principal federal agency that conducts and supports basic, clinical and translational medical research, and studies the causes, treatments, and cures for common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.
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