The 2025 GINA guidelines emphasize a personalized approach to asthma care, integrating biological, lifestyle, and environmental factors into treatment decisions. The “Assess-Adjust-Review” cycle encourages clinicians to:
- Assess: Confirm diagnosis, evaluate symptom control, and identify comorbidities.
- Adjust: Tailor treatment based on assessment, addressing modifiable risk factors such as inhaler technique, adherence, and environmental exposures.
- Review: Regularly monitor and adjust the treatment plan to ensure optimal control.
This approach aims to enhance patient outcomes by aligning treatment with individual needs and circumstances.
Treatment Strategies: Tracks 1 and 2
GINA maintains a two-track treatment strategy for adolescents and adults:
- Track 1: Utilizes as-needed low-dose ICS-formoterol as both maintenance and reliever therapy. This regimen has been shown to reduce the risk of severe exacerbations and corticosteroid exposure compared to SABA-based regimens.
- Track 2: Involves daily low-dose ICS with as-needed SABA.
For patients requiring higher doses, Track 2 Step 4 now recommends medium-dose ICS-LABA to minimize adverse effects associated with high-dose ICS. High-dose ICS-LABA should be limited to 3–6 months when necessary.
Type 2 Inflammation Biomarkers
The 2025 guidelines highlight the importance of Type 2 inflammation biomarkers in asthma management. Key biomarkers include:
- Blood eosinophil count
- Fractional exhaled nitric oxide (FeNO)
- Total serum immunoglobulin E (IgE)
- Allergen-specific IgE
These biomarkers aid in diagnosis, phenotype identification, monitoring, and predicting treatment response. Sputum eosinophil count can guide corticosteroid therapy in moderate to severe asthma, though its clinical availability is limited.
Asthma in Young Children
For children under 5 years with confirmed asthma and infrequent symptoms, low-dose ICS-formoterol as an anti-inflammatory reliever therapy is being investigated as a potential treatment option. This approach aims to provide effective control with minimal medication burden.
Climate Change and Asthma
The 2025 guidelines acknowledge the impact of climate change on asthma, categorizing effects into:
- Infrastructure: Climate-related disasters can damage healthcare infrastructure, disrupting access to medical care.
- Air Quality: Increased air pollution exacerbates asthma symptoms and exacerbations.
These factors necessitate adaptive strategies in asthma management to mitigate climate-related risks.
Diagnostic Considerations
The revised diagnostic algorithm emphasizes:
- Lung Function Assessment: Spirometry remains the gold standard for confirming asthma diagnosis.
- Biomarkers: While useful, biomarkers should be interpreted within the clinical context.
- Inhaler Technique and Adherence: Proper technique and adherence are critical for effective asthma control.
This approach ensures a comprehensive evaluation, leading to accurate diagnosis and tailored treatment plans.
Accessing the Guidelines
The full 2025 GINA Strategy Report is available for purchase through the official GINA website. Additionally, summary guides and slide sets are offered to assist healthcare professionals in implementing the updated recommendations. Global Initiative for Asthma – GINA
Learn the 2025 GINA Guidelines with CME Travel Academy
At CME Travel Academy, we make it easy for clinicians to stay current with evolving evidence. Our upcoming CME conferences — including sessions in Las Vegas, San Diego, and aboard a Caribbean cruise — will feature in-depth discussions of the 2025 GINA Asthma Guidelines, emphasizing how to implement the new recommendations in real-world practice. You’ll learn practical strategies for integrating ICS-formoterol–based regimens, assessing biomarkers of Type 2 inflammation, and personalizing therapy for both adults and children.
For those who prefer to learn online, our Online CME course offers the same high-yield, evidence-based content — with spaced repetition to reinforce key updates throughout the year and concise, point-of-care reference summaries for quick clinical use. Whether you join us in person or online, you’ll walk away confident in applying the latest GINA recommendations to improve asthma control and patient outcomes.