Asthma continues to be the commonest chronic respiratory illness and its prevalence is on the rise. Further, its control remains poor in spite of the wide availability and practice of GINA guidelines. Based on literature, the author is of the opinion that asthma can be better controlled with "Step in-Step down approach" (Initiating treatment of asthma with optimal dose of ICS along with LABA, withdrawal of LABA first during step down and finally reducing dose of ICS once control of asthma is sustained) rather than the Step up-step down approach" suggested by GINA.
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