Abstract

MORENO, Pablo et al. Recommendations for the Management and Treatment of Asthma in Argentina (RE.M.A) A RAND/UCLA modified Delphi consensus Argentinian Association of allergy and clinical immunology and Argentinian association of respiratory Medicine. Rev. am. med. respir. [online]. 2023, vol.23, n.4, pp.277-292. ISSN 1852-236X.  http://dx.doi.org/10.56538/ramr.jtge4865.

Asthma is a common chronic airway disease in our country, although with high poor con trol. Some specialists of the Asociación de Alergia e Inmunología Clínica and Asociación

Argentina de Medicina Respiratoria have made recommendations for management and treatment of asthma, using a RAND/UCLA modified Delphi consensus methodology, based on GRADE evidence.

This document provides recommendations based on specialist opinions about different strategies to improve adherence. Besides, it provides recommendations about critical issues of mild to severe asthma treatment.

It´s recommended to improve adherence, personalized control-based management plan (1 °C), mobile devices (1B) and education (1 °C). Sublingual immunotherapy must be prescribed only in patients with allergic rhinitis, mite associated, and persistent symptoms although appropriate treatment with FEV1> 70 % (1B). Use of fast action bronchodilators associated with inhaled corticosteroids prn in mild asthma (GINA stage 2) has strong recommendation (1A). Use of triple inhaled therapy (long acting anticholinergics, long acting beta 2 agonists and inhaled corticosteroids) is recommended in severe asthma (1B). Biologics has strong recommendations severe asthma: in phenotype T2 with du pilumab (1A), in phenotype allergic T2 with omalizumab (1A) and phenotype eosinophilic T2 with benralizumab or mepolizumab with distinctive characteristic (1A).

Keywords : Asthma; Adherence; Immunotherapy; Triple therapy; Biologics.

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