section 1. epr-3 versus gina 2008 guidelines - asthma control and step 3 care highlights of the asthma summit 2009 beyond the guidelines第一节。.pdfVIP

CONFERENCE PROCEEDINGS Section 1. EPR-3 versus GINA 2008 Guidelines – Asthma Control and Step 3 Care Highlights of the Asthma Summit 2009: Beyond the Guidelines Jean Bousquet, MD,1 and William W. Busse, MD2 ries based on the frequency of symptoms, exacerbations, noc- Abstract: Recent updates to asthma guidelines from the Global Ini- turnal symptoms, forced expiratory volume in the first second tiative for Asthma (GINA) and the National Asthma Education and 2 (FEV1), or peak expiratory flow (PEF) before treatment began. Prevention Program (Expert Panel Report 3, EPR-3) share many sim- However, many patients were already on treatment when phy- ilarities, reflecting a focus on asthma control based on clinical mani- sicians first saw them, making classification of disease severity festations of disease and responsiveness to therapy. Both documents build upon the recommendations of former guidelines utilizing evi- difficult. Later discussion suggested accounting for these pa- dence-based review of the published literature to revise algorithms for tients by classifying disease severity and recommending treat- practice. A major difference between the 2 reports is the preferred ment based on clinical features and step of medication regimen.3 treatment at Step 3. The GINA