GINA 2026: ICS-formoterol reliever options expand, and acute asthma care is revised

Design

Annual global strategy report, executive summary

Population

Children, adolescents and adults with asthma

Primary outcome

Recommendations for diagnosis, treatment and acute management

Effect

ICS-containing treatment for all; against SABA-only; ICS-formoterol reliever preferred in adults/adolescents; 2026 updates to reliever options, severe asthma and acute care

The Global Initiative for Asthma's 2026 executive summary restates the core: confirm the diagnosis objectively where possible, and review lung function, inhaler technique, adherence, comorbidities, Type 2 biomarkers and the patient's goals. Every adult, adolescent, child and most preschool children with asthma should receive inhaled corticosteroid-containing treatment, and SABA-only treatment is not recommended.

For adults and adolescents, the preferred track uses low-dose ICS-formoterol as an anti-inflammatory reliever, either as needed alone or as maintenance-and-reliever therapy, because it reduces severe exacerbations compared with SABA-based regimens. The 2026 changes expand anti-inflammatory reliever options for adults and children, revise guidance on severe asthma and choice of biologic, and substantially update acute asthma management, including the post-discharge review and action plan.

The specific new recommendations are in the full report; this summary signals where they are. In India, where SABA-only and oral salbutamol use remain common, the core message — no asthma without inhaled steroid — is still the one that changes most outcomes.

• Prescribe an inhaled corticosteroid-containing regimen for every patient with asthma; avoid SABA-only treatment.
• Consider as-needed or maintenance-and-reliever low-dose ICS-formoterol for adults and adolescents.
• Confirm the diagnosis with spirometry or peak flow variability where possible.
• Review inhaler technique and adherence before stepping up or adding a biologic.
• After an acute attack, review long-term treatment and give a written action plan before discharge.

Why it matters

It widens the anti-inflammatory reliever approach and revisits acute care, where most asthma deaths are preventable.

Don't overread it

This summary lists the areas changed; check the full report for the specific new recommendations.

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