Asthma: Diagnosis, Monitoring and Chronic Asthma Management (NICE NG80/BTS)

NICE NG80 provides guidance on the diagnosis and management of asthma in adults and children, including updated stepwise treatment ladder and monitoring approaches.

Key Recommendations

• Diagnosis: objective evidence of reversible airflow obstruction or bronchial hyperresponsiveness
• Step 1: As-needed SABA reliever inhaler
• Step 2: Add low-dose ICS (preventer). First-line: beclomethasone 200mcg/day or equivalent
• Step 3: Add LABA to ICS (combination inhaler). If inadequate: increase ICS dose
• Step 4: Refer to specialist. Consider LTRA, theophylline, or biologic therapy
• Biologics (dupilumab, mepolizumab, benralizumab) for severe eosinophilic asthma
• Annual asthma review for all patients: adherence, inhaler technique, written action plan