ASTHMA REVIEW

STUDIES OTHER


















AGES 5 - 11 YEARS
Mild Moderate Severe
FEV₁ ≥ 80% of predicted 61 - 79% of predicted ≤ 60% of predicted
FEV₁ / FVC > 80% 75 - 80% < 75%

AGES ≥ 12 YEARS
Mild Moderate Severe
FEV₁ ≥ 80% of predicted 61 - 79% of predicted ≤ 60% of predicted
FEV₁ / FVC normal reduced ≤ 5% reduced > 5%








0 - 4 YEARS OF AGE
Proceed to next step if no clear benefit after 4-6 weeks
All patients Step 1 Step 2 Step 3 Step 4 Step 5
Preferred
treatment
SABA as needed for immediate relief.
Corticosteroids with severe exacerbations.
low-dose ICS medium-dose ICS medium-dose ICS
+
either LABA or
montelukast
high-dose ICS
+
either LABA or
montelukast
high-dose ICS
+
either LABA or
montelukast
+
oral corticosteroids
Alternative
treatment
cromolyn or
montelukast


5 - 11 YEARS OF AGE
Reassess patient in 2 - 6 weeks and proceed to next step if needed
All patients Step 1 Step 2 Step 3 Step 4 Step 5
Preferred
treatment
SABA as needed for immediate relief.
Corticosteroids with severe exacerbations.
low-dose ICS low-dose ICS
+
either LABA, LTRA, or theophylline

OR

medium-dose ICS
medium-dose ICS
+
LABA
high-dose ICS
+
LABA
high-dose ICS
+
LABA
+
oral corticosteroids
Alternative
treatment
cromolyn, LTRA, or theophylline medium-dose ICS
+
either LTRA or theophylline
high-dose ICS
+
either LTRA or theophylline
high-dose ICS
+
either LTRA or theophylline
+
oral corticosteroids


≥ 12 YEARS OF AGE
Reassess patient in 2 - 6 weeks and proceed to next step if needed
All patients Step 1 Step 2 Step 3 Step 4 Step 5
Preferred
treatment
SABA as needed for immediate relief.
Corticosteroids with severe exacerbations.
low-dose ICS low-dose ICS
+
LABA

OR

medium-dose ICS
medium dose ICS
+
LABA
high-dose ICS
+
LABA

AND

consider omalizumab for patients who have allergies
high-dose ICS
+
LABA
+
oral corticosteroids

AND

consider omalizumab for patients who have allergies
Alternative
treatment
cromolyn, LTRA, or theophylline low-dose ICS
+
either LTRA, theophylline, or zileuton
medium-dose ICS
+
either LTRA, theophylline, or zileuton