GINA 2019: a fundamental change in asthma management: Treatment of asthma with short-acting bronchodilators alone is no longer recommended for adults and adolescents.

Competing Interests: Conflict of interest: H.K. Reddel reports grants and personal fees for data monitoring committee and advisory board work, and providing independent medical education and consultancy from AstraZeneca, grants, personal fees for data monitoring committee and advisory board work, and providing independent medical education and consultancy, and non-financial support (study medication) from GlaxoSmithKline, personal fees for data monitoring committee work from Merck, grants and personal fees for data monitoring committee and advisory board work, and providing independent medical education from Novartis, personal fees for providing independent medical education from Teva and Mundipharma, personal fees for advisory board work and providing independent medical education from Boehringer Ingelheim, outside the submitted work; and H.K Reddel is Chair of the GINA Scientific Committee. Conflict of interest: J.M. FitzGerald reports grants and personal fees for advisory board work and speaker bureau-related presentations from AstraZeneca, GSK and Sanofi Regeneron, grants from Novartis, Boehringer Ingelheim and TEVA, during the conduct of the study; and is a member of the Executive and Science Committees of GINA. Conflict of interest: E.D. Bateman is a member of the Science Committee and Board of GINA; reports personal fees from ALK, AstraZeneca, Boehringer Ingelheim, Cipla, Menarini, Novartis, Orion, Regeneron, Sanofi Genzyme and Vectura, and grants to his institution from AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, Novartis, Sanofi-Aventis and TEVA, outside the submitted work. Conflict of interest: L.B. Bacharier reports personal fees for lecturing and consultancy from Aerocrine, GlaxoSmithKline, Genentech/Novartis, Teva, Boehringer Ingelheim and AstraZeneca, personal fees for advisory board work from Merck and Circassia, personal fees for data monitoring committee work from DBV Technologies, personal fees for CME programme development from WebMD/Medscape, personal fees for lecturing and advisory board work from Sanofi/Regeneron, personal fees for consultancy and advisory board work from Vectura, outside the submitted work. Conflict of interest: A. Becker reports personal fees for continuing medical education from AstraZeneca, personal fees for lecturing from Johnson and Johnson, and MSD, personal fees for advisory board work from Novartis, outside the submitted work. Conflict of interest: G. Brusselle reports personal fees for lecturing and advisory board work from AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Novartis and Teva, personal fees for advisory board work from Sanofi, outside the submitted work. Conflict of interest: R. Buhl reports personal fees from AstraZeneca, Boehringer Ingelheim, Chiesi, Cipla, Novartis, Roche, and Teva, outside the submitted work, as well as grants to Mainz University from Boehringer Ingelheim, GlaxoSmithKline, Novartis, and Roche, also outside the submitted work. Conflict of interest: A.A. Cruz reports grants and personal fees for advisory board work from GSK, grants, personal fees for lecturing and advisory board work and non-financial support for meeting attendance from AstraZeneca, personal fees for lecturing, developing educational materials and advisory board work, and non-financial support for meeting attendance from Boehringer Ingelheim, personal fees for lecturing and non-financial support for meeting attendance from Chiesi, personal fees for lecturing and developing educational materials, and non-financial support for meeting attendance from EUROFARMA and MEDA Pharma, personal fees for lecturing from Novartis, personal fees for consultancy and advisory board work from Sanofi, outside the submitted work. Conflict of interest: L. Fleming reports grants from Asthma UK, and speaker and consutancy fees, all paid direct to her institution, from Boehringer Ingelheim, AstraZeneca, GSK, Sanofi, Respiri and Novartis, outside the submitted work. Conflict of interest: H. Inoue reports grants from Boehringer Ingelheim, Kyorin, MeijiSeikaPharma, Novartis, Ono, Taiho and Teijin-Pharma, personal fees for lecturing and advisory board work from Astellas, AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, Kyorin, Merck Sharp & Dohme, Novartis, Otsuka and Sanofi, outside the submitted work. Conflict of interest: F.W. Ko has nothing to disclose. Conflict of interest: J.A. Krishnan reports research grants from the US National Institutes of Health (current), research contracts from the US Patient Centered Outcomes Research Institute (current), and personal fees from Sanofi to serve on an independent data monitoring committee, outside the submitted work. Conflict of interest: M.L. Levy reports personal fees for consultancy from Clement Clarke International, personal fees for lecturing from Teva and Soar Beyond, personal fees for advisory board work from AstraZeneca, Orion Pharmaceuticals, GlaxoSmithKline and Trudel Pharmaceuticals, non-financial (travel) support from and is a board member of GINA, personal fees for data monitoring committee work and travel support from Chiesi, grants from Conzorcio Futuro In Ricerca, support for meeting attendance from Napp Pharmaceuticals, personal fees for consultancy from National Services for Health Improvement, a company providing services for practices (Nurse asthma reviews), personal fees for lecturing and advisory board work from Novartis Pharmaceuticals, and support from Whole Systems Integrated Care (WSIC) for whom M.L. Levy is lead on asthma and joint lead for COPD in developing dashboards for clinical care for general practitioners in London, outside the submitted work. Conflict of interest: J. Lin has nothing to disclose. Conflict of interest: S.E. Pedersen reports personal fees for lectures and consultancy from Astrazeneca, personal fees for consultancy from ALK and Thermofisher, outside the submitted work. Conflict of interest: A. Sheikh reports support for meeting attendance from GSK, grants from Asthma UK, and other support from the Scottish Allergy and Respiratory Academy (a not-for-profit training initiative for health care professionals supported by a consortium of industry funders), outside the submitted work. Conflict of interest: A. Yorgancioglu reports grants from MSD, personal fees for advisory board work from GSK, personal fees for advisory board work and lecturing from AstraZeneca, Abdi İbrahim, Chiesi, Novartis and Sandoz, outside the submitted work. Conflict of interest: L-P. Boulet reports research grants for participation in multicentre studies from AstraZeneca, Boston Scientific, GlaxoSmithKline, Hoffman La Roche, Novartis, Ono Pharma, Sanofi and Takeda; support for research projects from AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, Merck and Takeda; fees for consulting and advisory board work from AstraZeneca, Novartis and Methapharm; royalties as co-author of “Up-To-Date” (occupational asthma); nonprofit grants for production of educational materials from AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, Merck, Frosst and Novartis; conference fees from AstraZeneca, GlaxoSmithKline, Merck and Novartis; support for participation in conferences and meetings from Novartis and Takeda; is past president and member of the Canadian Thoracic Society Respiratory Guidelines Committee; Chair of the Board of Directors of the Global Initiative for Asthma (GINA); Laval University Chair on Knowledge Transfer, Prevention and Education in Respiratory and Cardiovascular Health; member of scientific committees for the American College of Chest Physicians, American Thoracic Society, European Respiratory Society and the World Allergy Organization; 1st Vice-President of the Global Asthma Organization “InterAsma”.