GINA: patients should stick with steroids during COVID-19 pandemic

24 Mar 2020

The Global Initiative for Asthma (GINA) has had to issue advice for people with asthma to continue using their controller medications including inhaled and even oral corticosteroids, assuming there is “a clear indication for their use”.

The advice follows confusion about COVID-19 and the risk of immunosuppression with corticosteroids. 

“Stopping inhaled corticosteroids often leads to potentially dangerous worsening of asthma, and avoiding oral corticosteroids during severe asthma attacks may have serious consequences,” GINA said.

GOLD has also issued similar advice for patients with COPD. 

“GOLD is not aware of any scientific evidence to support that inhaled (or oral) corticosteroids should be avoided in patients with COPD during the COVID-19 epidemic.”

“COPD patients should maintain their regular therapy,” GOLD said.

— GOLD COPD (@GOLD_COPD) March 23, 2020

The National Asthma Council Australia has also reinforced the message to patients to continue with inhaled corticosteroids (ICS).

They also advised against the use of nebulisers which can potentially disperse virus particles for up to metres.  

Meanwhile the COVID-19 induced panic buying of products such as Ventolin has raised the question of whether this is an ideal time to educate asthma patients about the benefits of using combination products such as low dose ICS-formoterol as a reliever. 

As previously reported in the limbic, GINA’s 2019 Global Strategy for Asthma Management and Prevention recommended against SABA relievers alone.

And locally, the National Asthma Handbook says “Low-dose budesonide/formoterol combination can be used as reliever for asthma symptoms (instead of using a short-acting beta2 agonist reliever), in addition to its use as regular long-term preventer treatment.”

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