Kenneth Chapman, MD: Interpreting Global Perspectives on GINA Asthma Recommendations

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Results from the 2 APPaRENT trials suggest regular inhaled corticosteroids/LABA alone or with short-acting beta agonists were the preferred treatment approach with physicians.

Results from APPaRENT studies 1 and 2 indicated that physicians regard symptom control as the most important treatment goal for patients with moderate asthma, with regular inhaled corticosteroids/long-acting beta-agonists alone or with short-acting beta agonists being the preferred treatment approach.

The data were presented today at the American Thoracic Society 2020 International Conference in San Francisco.

In an interview with HCPLive, study author Kenneth Chapman, MD, from the University of Toronto, detailed the 2 treatment track recommendations issued by the Global Initiative for Asthma (GINA) in 2021, and the perspectives gained from the 2 APPaRENT surveys.

Track 1 recommends low-dose ICS use as a maintenance and reliever therapy, while track 2 recommends daily ICS/LABA use with as-needed SABA for symptom relief.

Chapman noted that the responses in the APPaRENT trials suggested that physicians are currently more aligned with track 2 recommendations.

“To be succinct – which is hard for an academic- clinicians and their patients seem to like track 1; the notion that one gives a regular maintenance treatment and prevents symptoms, (with) symptoms control being a primary goal,” Chapman said. “Patients and physicians are telling us prevention are their goal.”

Chapman noted that GINA, while replete with “great investigators in asthma”, does not produce guidelines but rather strategies for dealing with asthma. As such, he feels that the data presented from these global surveys support the idea of challenging and discussing these strategies to better treat moderate adult asthma.

“One of the things I’d love to do is wake up physicians to the notion that their seeing hypothesis when they see GINA recommendations, and that you have to look critically at those hypotheses and see how they might play at in your practice,” Chapman said. “What we’ve seen in our survey of 8 nations is that clinicians and patients are still pursuing the traditional preventive route.”

Watch the full interview above to hear more from Dr. Chapman, and click here for more news from ATS 2022.