Recommendation ID

Starting asthma treatment:- In adults, young people and children with asthma who have not been treated previously, is it more clinically and cost effective to start treatment with a reliever alone (a short-acting beta2 agonist [SABA]) or with a reliever (a SABA) and maintenance therapy (such as ICS)? Are there specific
prognostic features that indicate that one of these treatment options may be more appropriate for some groups?

Any explanatory notes
(if applicable)

Why this is important:- Recently best practice has shifted from starting people with asthma on a SABA as a reliever alone and starting maintenance therapy only if the person continues to have persistent asthma symptoms, to starting people on a low dose inhaled corticosteroid (ICS) as maintenance therapy alongside the SABA at the first instance. The committee agree with this shift and have included consensus-based recommendations in line with this pattern. However, the shift is not based on
direct clinical evidence comparing these strategies for people with newly diagnosed asthma. There is also little evidence to support the particular groups in which one option or the other is more appropriate.

Source guidance details

Comes from guidance
Asthma: diagnosis, monitoring and chronic asthma management
Date issued
November 2017

Other details

Is this a recommendation for the use of a technology only in the context of research? No  
Is it a recommendation that suggests collection of data or the establishment of a register?   No  
Last Reviewed 30/11/2017