Fig. 7. Investigating and managing difficult-to-treat asthma in adult and adolescent patients.

ICS inhaled corticosteroid, LABA long-acting beta₂ agonist, LAMA long-acting muscarinic antagonist, LTRA leukotriene receptor antagonists, SABA short-acting beta₂ agoinst, OCS oral corticosteroid. The GINA strategy includes a decision tree about the management of difficult-to-treat and severe asthma spanning primary through tertiary care. The section of the flow diagram applicable to generalists in primary and secondary care is shown here. Source: Box 3–16A in GINA report 2022. Reproduced with permission from ref. ¹¹.