Figure 2.

Stepped approach to pharmacological therapy according to the German National Disease Management Guideline (Nationale Versorgungsleitlinie) 2020 (7)

Following GINA, the German National Disease Management Guideline recommends a five-step approach to treatment. Depending on the level of asthma control, medications are stepped up or down until good asthma control is achieved with as few medications as possible at the lowest possible dosage.

Modified from (7).

*¹ Fixed-dose combination (low-dose ICS + formoterol) on an as-needed basis is not approved for steps 1 and 2 (as of February 2020)

*² ICS+formoterol as needed if this combination is also used for maintenance therapy

GINA, Global Initiative for Asthma; ICS, inhaled corticosteroid; LABA, long-acting β₂-agonist; LAMA, long-acting muscarinic antagonist;

LTRA, leukotriene receptor antagonist; OCS, oral glucocorticosteroid; SABA, short-acting inhaled β₂-agonist