Global Initiative for Asthma (GINA) guideline: Achieving optimal asthma control in children aged 6-11 years

Document Type



Paediatrics and Child Health


The Global Initiative for Asthma (GINA) 2021 guidelines for asthma have been set forth with some alterations in Step 3, for children from 6-11-year-old age group. The low dose LABA-ICS, very low dose formoterol-ICS, medium dose ICS and ICS-LTRA combination were recommended in the guideline. We organized this study to draw an effective comparison between these three combinations of controller therapies in pediatric population. A retrospective study was conducted at the Aga Khan University Hospital, Karachi, Pakistan which enrolled 114 children aged 6-11 years old, from July 2021 to December 2022. These children were admitted with asthma exacerbations and were discharged on controller medications as per GINA guidelines on step 3 for control of asthma for 3 months. They were then followed for re-admission within 30 days of discharge, number of ER visits with asthma exacerbations for 1 year, number of admissions with asthma including HDU and PICU admissions, length of stay per admission for all admissions in subsequent one year. The pulmonary function test was done at 1 week follow-up in clinic after discharge and at 3 months visit post discharge. A total of 114 pediatric patients from age 6-11-year-old, were enrolled in the study period out of which 36 (31.57%), 33(28.9%) and 34 (29.82%) patients were categorized into ICS-LABA, ICS and ICS-LTRA groups respectively. ER visits were significantly low in ICS-LABA group followed by ICS-LRTA group and then ICS group (1.75±0.96 vs 2.93±1.412 vs 3.11±1.21, p


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Publication (Name of Journal)

Monaldi Archives for Chest Disease