The 2026 GINA strategy report summary, published in AJRCCM, restates its core position: all adults, adolescents, children and most preschoolers with asthma should receive inhaled corticosteroid-containing treatment, and short-acting beta-agonist (SABA)-only treatment is not recommended.
For adults and adolescents, the preferred approach (Track 1) 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 update expands anti-inflammatory reliever options for adults and children, revises guidance on severe asthma and biologic choice, and substantially updates acute asthma management, including reviewing long-term treatment after an exacerbation.
In India, SABA-only prescribing remains common and budesonide-formoterol is widely available. Switching a patient using a salbutamol inhaler alone to an ICS-containing reliever is the single change most likely to prevent severe attacks.
- Do not prescribe SABA-only treatment for asthma
- Prefer as-needed low-dose ICS-formoterol, or maintenance-and-reliever therapy, for adults and adolescents
- Confirm the diagnosis objectively with spirometry or peak flow variability where possible
- After any exacerbation, review long-term treatment and the action plan before discharge
- Use type 2 biomarkers to guide biologic choice in severe asthma
Why it matters
SABA-only treatment is still common and is linked to preventable severe attacks.
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