Adapted Evidence-Based Clinical Guidelines: Bronchial Asthma (Part 3)

Abstract

C. Clinical guideline is the result of an agreed decision of experts, adopted on the basis of a thorough analysis of literature data, as well as recommendations of foreign guideline GINA: Global Strategy For Asthma Management And Prevention. Updated 2019. The document provides an updated definition of bronchial asthma (BA), gives new approaches to the classification and diagnosis of the disease, proposes modern treatment regimens based on the results of multicenter international clinical trials, which justifies the high evidence for such therapeutic tactics. New principles for the distribution of patients to phenotypes, which should be taken into account when choosing treatment regimens, are presented, algorithms for initial and maintenance therapy, and new approaches to the treatment of exacerbations of the disease are presented. In previous publications of the manual (Asthma and Allergy, 2020, № 2, № 3), an updated definition and pathogenetic mechanisms of BA were presented, new approaches to the classification and diagnosis of the disease were outlined, and the definition and assessment of asthma control were given. The principles of assessing the severity of asthma, as well as the difference between severe and uncontrolled asthma are considered. Standards for the treatment of asthma patients according symptoms control and minimize risk are presented. The basic principles of asthma management and alternative correction strategies of treatment are considered. The third part of the manual presents a stepwise approach to the correction of therapy, immunotherapy with allergens, vaccination, indications for referral to a specialist consultation. The guideline is addressed to doctors at all levels of medical care – family doctors, general practitioners, pulmonologists, allergists, cardiologists, rehabilitologists. Key words: bronchial asthma, pathogenesis, classification, diagnosis, therapy