The 2026 Global Initiative for Asthma strategy report keeps its central recommendations. All adults, adolescents, children and most preschool children with asthma should receive treatment containing an inhaled corticosteroid, and SABA-only treatment is recommended against. For adults and adolescents, the preferred pathway uses low-dose ICS-formoterol as an anti-inflammatory reliever, either as needed alone or as maintenance-and-reliever therapy, because it substantially 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. Throughout, GINA stresses confirming the diagnosis objectively, checking inhaler technique and adherence, assessing type 2 biomarkers, and reducing oral steroid use.
In India, where salbutamol-only treatment and repeated oral steroid courses remain common, the most important message is unchanged: every patient with asthma needs an inhaled steroid.
- Do not prescribe a SABA inhaler alone for asthma at any age where GINA recommends ICS.
- For adults and adolescents, consider low-dose ICS-formoterol as the reliever, with or without maintenance.
- Confirm the diagnosis with spirometry or peak-flow variability where possible.
- Check inhaler technique and adherence at every review.
- Review management and the action plan after every acute attack.
Why it matters
SABA-only treatment remains common and leaves patients exposed to severe attacks.
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