Table 3.

Stepwise approach to asthma therapy¹–⁴

Step 1	Step 2	Step 3	Step 4	Step 5	Step 6
Preferred: SABA as needed	For 6–8 weeks Preferred: Low-dose ICS Alternative: LTRA	Preferred: Low-dose ICS + LABA or medium-dose ICS Alternative: Low-dose ICS + LTRA	Preferred: Medium-dose ICS + LABA Alternative: Medium-dose-ICS + LTRA	Preferred: High-dose ICS + LABA and LTRA. Consider omalizumab for patients with allergies	Preferred: High-dose ICS + LABA and LTRA. Consider tiotropium and omalizumab for patients with allergies	Step up when needed (first check adherence, inhaler technique, and environmental control) Assess control: Step down if possible when asthma is well-controlled for at least 3 months

Abbreviations: ICS, inhaled corticosteroids; LABA, long-acting β₂-agonists; LTRA, leukotriene receptor agonists; SABA, short-acting β₂-agonists.