Asthma and Respiratory Foundation NZ Adolescent and Adult Asthma Guidelines 2020: a quick reference guide.

The purpose of the 2020 Asthma and Respiratory Foundation NZ Adolescent and Adult Asthma Guidelines is to provide simple, practical and evidence-based recommendations for the diagnosis, assessment and management of asthma in adolescents and adults (aged 12 and over) in a quick reference format. The intended users are health professionals responsible for delivering asthma care in the community and hospital settings, and those responsible for the training of such health professionals. The main changes in the 2020 update are: 1) combining the recommendations for both adolescents and adults in a single document, 2) the recommendation to avoid SABA-only treatment in the long-term management of asthma, 3) the use of budesonide/formoterol reliever, with or without maintenance budesonide/formoterol, is preferred to SABA reliever, with or without maintenance ICS or ICS/LABA, across the spectrum of asthma severity, 4) introduction of the terminology 'anti-inflammatory reliever (AIR)' therapy to describe the use of budesonide/formoterol as a reliever medication, with or without maintenance budesonide/ formoterol therapy. This approach encompasses and extends the 'Single combination ICS/LABA inhaler Maintenance And Reliever Therapy' (SMART) approach recommended in the previous guideline, 5) the inclusion of two stepwise management algorithms, 6) a clinical allergy section, 7) the role of LAMA therapy in severe asthma, 8) the role of omalizumab in severe allergic asthma and mepolizumab in severe eosinophilic asthma, 9) an appendix detailing educational materials.
Competing Interests: Richard Beasley has received payment for lectures from and been a member of the AstraZeneca, Avillion, GlaxoSmithKline and Theravance advisory boards, and received research grants from AstraZeneca, Cephalon, Chiesi, Genentech, GlaxoSmithKline and Novartis. Lutz Beckert has received payment for lectures and/or advisory boards from AstraZeneca, GlaxoSmithKline, Novartis, and Boehringer Ingelheim. James Fingleton reports research grants from AstraZeneca, payment for lectures and non-financial support from AstraZeneca, research grants from Genentech, payment for lectures and non-financial support from Boerhinger Ingleheim. Robert Hancox has received payment to his institution for lectures and/or advisory boards from AstraZeneca, GlaxoSmithKline, and Novartis and non-financial support from Boehringer Ingelheim. Stuart Jones has received payment for educational lectures from AstraZeneca and GlaxoSmithKline. Jim Reid is a member of the GlaxoSmithKline Expert Advisory Committee and has received payment for lectures or educational activities form GSK, AstraZeneca, and Boehringer Ingelheim. Matire Harwood, Miriam Hurst, Susan Jones, Betty Poot and Ciléin Kearns have no conflicts to declare.