GINA 2026 asthma strategy updates reliever options, biologic selection and acute management

The 2026 Global Initiative for Asthma (GINA) Strategy Report executive summary outlines an annually updated, evidence-based approach to asthma diagnosis, assessment, treatment and prevention across the lifespan. Published in the American Journal of Respiratory and Critical Care Medicine, the summary emphasizes personalized care through an Assess-Adjust-Review cycle addressing symptom control and future risk. Assessment includes objective diagnostic confirmation where possible, lung function, inhaler technique, adherence, multimorbidity and patient preferences.

GINA strongly recommends inhaled corticosteroid (ICS)-containing treatment for adults, adolescents, children and most preschoolers with asthma, and recommends against short-acting beta2-agonist (SABA)-only treatment. For adults and adolescents, preferred Track 1 treatment uses low-dose ICS-formoterol as an anti-inflammatory reliever, either as needed alone or as maintenance-and-reliever therapy. The summary cites fewer severe exacerbations compared with SABA-based regimens and simpler treatment, but provides no numerical effect estimates.

Key 2026 changes include expanded anti-inflammatory reliever options for adults and children, revised severe asthma guidance and biologic treatment selection, and substantial acute management updates. Severe asthma care emphasizes diagnostic verification, modifiable factors, inflammatory phenotyping and systemic corticosteroid stewardship. Exacerbation care includes preventive treatment and post-discharge reassessment of management and action plans. Only the abstract was available; specific new regimens, eligibility criteria and supporting evidence could not be assessed.