A new stepwise treatment graphic to emphasise key messages. A new stepwise treatment figure visually
reinforces the link between the “assess − adjust treatment – review response” cycle (figure 1) and
treatment selection. Step 2 treatment now comprises a larger component of the figure, to emphasise that
most patients with asthma should be treated with, and are likely to respond to, low-dose ICS. For each
step, the figure shows not only the “preferred controller choice” but also “other controller options” that
DOI: 10.1183/13993003.00853-2015 7
ASTHMA CONTROL | H.K. REDDEL ET AL.
may be considered in low-resource countries or as part of tailoring treatment. The two options for reliever
medication are shown, i.e. SABA, or low dose ICS/formoterol for patients prescribed maintenance and
reliever regimens. In the 2015 GINA update, add-on tiotropium by soft-mist inhaler is included in Step 4
and Step 5 as an “other controller option” for adults (⩾18 years) with exacerbations, following regulatory
approval for this indication. Key clinical messages are included beneath the stepwise figure, to ensure that
it is complete in itself if the figure is viewed in isolation from the surrounding text.