Pathways

Pathways

NICE 2017 Asthma in adults

NICE 2017 Asthma in adults

Interactive NICE 2017 Asthma in adults pathway

Consider decreasing maintenance therapy when asthma has been controlled for at least 3 months

Step up if uncontrolled after 4–8 weeks of treatment

SABA as reliever *

Step 1

Offer low dose ICS

Step 2

Offer LTRA in addition to low dose ICS

Step 3

Offer LABA in addition to low dose ICS; remove LTRA if necessary

Step 4

Offer LABA and low dose ICS as MART regimen; remove LTRA if necessary

Step 4a

Consider moderate dose ICS and LABA as MART regimen; remove LTRA if necessary
OR

Step 4b

Consider moderate dose ICS and LABA as a fixed dose; remove LTRA if necessary

Step 5

Consider additional options

Consider trials of high dose ICS and LABA; remove LTRA if necessary

Or, consider addition of LAMA or SR theophylline