Spanish Asthma Management Guidelines (GEMA) VERSION 5.1. Highlights and Controversies

Arch Bronconeumol (Engl Ed). 2021 May 26;S0300-2896(21)00165-4. doi: 10.1016/j.arbres.2021.05.010. Online ahead of print.
[Article in English, Spanish]

Abstract

In this fifth phase of development, the contents of the Spanish Asthma Management Guidelines (GEMA), which include versions 5.0 and 5.1, have undergone a thorough review. The aim here is to set the main changes in context. These could be summarized as follows: DIAGNOSIS: new FENO cut-off and severity classification based on treatment needed to maintain control; INTERMITTENT ASTHMA: a more restrictive concept and treatment extended to include a glucocorticoid/adrenergic combination as needed; MILD ASTHMA: glucocorticoid/adrenergic therapy as needed as an alternative in case of low therapeutic adherence to conventional fixed-dose steroids; SEVERE ASTHMA: readjustment of phenotypes, incorporation of triple therapy in a single inhaler, and criteria for selection of a biologic in severe uncontrolled asthma; OTHERS: specific scoring in childhood asthma, incorporation of certain organizational aspects (care circuits, asthma units, telemedicine), new sections on COVID-19 and nasal polyposis.

Keywords: Asma; Asthma; Clinical practice guidelines; Consenso; Consensus; Evidence-based medicine; Guía de práctica clínica; Medicina basada en la evidencia.