Section 1. EPR-3 versus GINA 2008 guidelines - asthma control and step 3 care: Highlights of the asthma summit 2009: beyond the guidelines

Abstract : Recent updates to asthma guidelines from the Global Initiative for Asthma (GINA) and the National Asthma Education and Prevention Program (Expert Panel Report 3, EPR-3) share many similarities, reflecting a focus on asthma control based on clinical manifestations of disease and responsiveness to therapy. Both documents build upon the recommendations of former guidelines utilizing evidence-based review of the published literature to revise algorithms for practice. A major difference between the 2 reports is the preferred treatment at Step 3. The GINA guidelines recommend a combination of low-dose inhaled corticosteroid (ICS) plus long-acting β-agonist (LABA), whereas the EPR-3 advises either monotherapy with medium-dose ICS or the low-dose ICS + LABA combination. Both approaches are supported by clinical experience and Level A evidence. The option of personalized therapy is a point of discussion for future guidelines.