Talk:Asthma
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Adding to Management Section of Asthma Page
I am planning on editing the Asthma page to include e-cigarettes/vaping as one of the potential identifying triggers. As e-cigarettes and vaping have become more common in recent years, I have been reading about the effects it can have on respiratory diseases and how it can be a trigger. I will be using research articles as my sources. Elvar002 (talk) 04:31, 11 April 2025 (UTC)
- Great. Please ensure that the sources you will use are high-quality, peer-reviewed medical studies. Chronos.Zx (talk) 16:51, 23 June 2025 (UTC)
Update needed
The article still has really good bones, but the median source age is 2011. Anybody here feel up to the task to compare the article with newer clinical guidelines and review papers? For instance, using the 2024 NICE guidelines, rather than the 2007 ones currently cited in the article. We're starting a project at WP:WikiProject Medicine to get all our top-importance articles up to date. —Femke 🐦 (talk) 13:46, 30 October 2025 (UTC)
Semi-protected edit request on 19 November 2025
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{{subst:trim|1=
Add "A meta-analysis has concluded that short-term pollen exposure significantly increases the risk of allergic and asthmatic symptoms." to the 'Environmental' subsection under the 'Causes' content header. [1]
Not done: please provide reliable sources that support the change you want to be made. NotJamestack (✉️|📝) 12:50, 19 November 2025 (UTC)
- Also, please put this in your own words. NotJamestack (✉️|📝) 12:51, 19 November 2025 (UTC)
GA Reassessment
Asthma
- Article (edit | visual edit | history) · Article talk (edit | history) · Watch • • Most recent review
- Result pending
This top-importance Medicine article was listed in 2013, and has not been kept up-to-date. Opening the GAR in the hope of finding someone who would like to give the article a once-over
- In contrast to WP:MEDDATE, the article's median source year is 2011
- The economics section is US-focussed, and ends in 2010
- The 2007 NICE guidelines are cited, even though the 2024 guidelines are out
- The genetic evidence stops in 2005(!). Surely, more is known now about which genes contribute to asthma risk. —Femke 🐦 (talk) 07:13, 23 November 2025 (UTC)
- I’m willing to take this on if I can have some time to wrap up my studies and the Coeliac disease article (studies wrap up in 2 weeks and i’m hoping the CD article will wrap up around them as well) IntentionallyDense (Contribs) 05:05, 25 November 2025 (UTC)
- Okay so this seems to be quite a big project. This is not something I will reasonably be able to do in under a month but I'm going to chip away at it. I'm going to start by removing some information that is not mentioned in recent sources and go from there. Seeing as this is a huge article I don't think it needs tons of info added moreso just some reshuffling of existing info and updating. IntentionallyDense (Contribs) 18:52, 13 December 2025 (UTC)
- A lot of progress has been made but I am very busy lately. Thank you for our patience so far and I would appreciate some more time to finish up the last bits that need to be wrapped up. Just wanted to clarify that I have not given up on this article. IntentionallyDense (Contribs) 16:49, 14 March 2026 (UTC)
Guideline updates
- GINA guidelines: The scope of the 2011 and 2025 GINA guidelines closely match. In most cases, citations to the 2011 guideline can be replaced with citations to the 2025 guideline, provided that the accompanying text is updated to reflect current recommendations.
- GINA_2011: "Global Strategy for Asthma Management and Prevention" (PDF). Global Initiative for Asthma. 2011. Archived Reports.
- GINA_2025: "Global Strategy for Asthma Management and Prevention" (PDF). Global Initiative for Asthma (GINA). 2025.
- NICE / SIGN guidelines: The scopes of SIGN 101 and SIGN 158 closely match, whereas NICE NG245 has a narrower focus. As a result, citations to SIGN 101 can generally be replaced with SIGN 158, but not with NG245.
- SIGN 101: "British Guideline on the Management of Asthma" (PDF). British Thoracic Society. 2012 [2008]. SIGN 101. Archived from the original (PDF) on August 19, 2008. Retrieved August 4, 2008.
- SIGN 158: British Guideline on the Management of Asthma. British Thoracic Society. July 2019. ISBN 978-1-909103-70-2. SIGN 158.
- NG245: British Thoracic Society; National Institute for Health and Care Excellence; Scottish Intercollegiate Guidelines Network (November 2024). "Asthma: diagnosis, monitoring and chronic asthma management". NICE guideline NG245. NICE.
- NHLBI guidelines: The scope of the 2020 NHLBI focused update is substantially narrower than that of the 2007 NHLBI/NAEPP guidelines (EPR-3). The 2007 guideline therefore remains generally valid except where its recommendations have been superseded by the 2020 focused update. Consequently, most citations to the 2007 guideline cannot be replaced by the 2020 update.
- NHLBI_2007: Expert Panel (2007). Guidelines for the Diagnosis and Management of Asthma. National Asthma Education and Prevention Program (Report). National Heart, Lung, and Blood Institute. Report 3 (EPR-3).
- NHLBI_2020: National Asthma Education and Prevention Program Coordinating Committee. "Asthma management guidelines: Focused updates 2020". National Heart, Lung, and Blood Institute.
Boghog (talk) 10:44, 16 December 2025 (UTC)
Update
@Femke, IntentionallyDense, and Boghog: What is the status of this GAR? Z1720 (talk) 17:42, 15 January 2026 (UTC)
Done genetic evidence section completely rewritten and supported with recent MEDRS compliant sources- Done GINA_2011 → GINA_2025
- Done SIGN 101 → SIGN 158
Not done NHLBI_2007 → NHLBI_2020 (not possible since scope of NHLBI_2020 is much narrower than NHLBI_2007)- Boghog (talk) 20:08, 15 January 2026 (UTC)
- It's being worked on, still left to do are the following:
- Rework lead. Ideally no citations as especially with the rp template, they clutter things
- Update associated conditions. Includes removing exact percentages as they aren't that helpful to readers IMO and they get outdated easily
- Classification. Trim the second para and the asthma exacerbation subheading (overly technical at times) Condense the 3 subtypes remaining into above paragraphs. Add a bit more info on symptom control and severity
- Causes. Currently working on this in a sandbox User:IntentionallyDense/Asthma but basically just condense info and update it
- Pathophysiology. Update it and possibly simplify it a bit
- Diagnosis. Update and condense
- Update prognosis and epidemiology
- Combine the economy and health disparities into a society and culture section
- History needs a bit of tidying.
- This is not an easy or quick job, I'm currently in school and working so my time is limited but as with the coeliac disease page, I will get it done, I just need some time. IntentionallyDense (Contribs) 21:00, 15 January 2026 (UTC)
- Cancerning {{rp}}, these will be replaced later this year with Sub-referencing which is a much cleaner solution. Harvard-style referencing fragments citation information between inline notes and the reference list, requiring readers to jump between sections to understand precisely what part of a source supports a claim. Sub-referencing keeps page and chapter details directly beneath the full citation, allowing readers to verify sources immediately and with less effort. Boghog (talk) 09:42, 16 January 2026 (UTC)
I see work in going quite well. I do notice quite a few quite technical bits being introduced however. For instance, the lead uses the terms bronchioles and alveoli, without explaining them. Not sure if it's possible to simplify the treatment section of the lead, but it comes across as more technical than our typical reader might need. In the genetics section, loci is not explained, atopic isn't defined (is it a necessary word?). In general the genetic correlation paragraph is tough to understand. —Femke 🐦 (talk) 12:59, 12 February 2026 (UTC)
- @Femke, IntentionallyDense, and Boghog: Can we get an update on this? I see that it has been several weeks since the article was significantly edited. Z1720 (talk) 02:07, 19 March 2026 (UTC)
- There was a update a few days back: more work is planned :). —Femke 🐦 (talk) 07:27, 19 March 2026 (UTC)
- scroll up, i made an update a couple days ago. in the future i’ll make updates towards the bottom of the page so its easier for you to see them when checking GAR that have been open for awhile. IntentionallyDense (Contribs) 06:01, 22 March 2026 (UTC)
Trimming management section
I plan on trimming the management section as it is currently very long and has a lot of duplicated information. This section may be appropriate as separate article and if anyone wants to create that, the revision before I started removing information is Special:Permalink/1326994836 IntentionallyDense (Contribs) 18:46, 15 December 2025 (UTC)
Management section
Okay I'm in a bit of a pickle here and I'm going to ping some of the most knowledgeable people I know on guidelines and medical topics @Spicy, Femke, WhatamIdoing, Casliber, Graham Beards, Colin, and SandyGeorgia:
I don't think I've ever seen a managment section like this one. Ignoring the fact that it is outdated, you read through 4 paragraphs only to then get into the 8 subsections on the topic. I'm not too concerned about the repeatitiveness, that is an easy fix, what is puzzling is the amount of treatments mentioned that are either not used in practice, not affective, or just out of place. I'm going to list all the examples of this:
- Older, less selective adrenergic agonists, such as inhaled epinephrine, have similar efficacy to SABAs. They are, however, not recommended due to concerns regarding excessive cardiac stimulation
- Other remedies, less established, are intravenous or nebulized magnesium sulfate and helium mixed with oxygen. Aminophylline could be used with caution as well
- Intravenous administration of the drug aminophylline does not provide an improvement in bronchodilation when compared to standard inhaled beta2 agonist treatment. Aminophylline treatment is associated with more adverse effects compared to inhaled beta2 agonist treatment
- Mast cell stabilizers (such as cromolyn sodium) are safe alternatives to corticosteroids but not preferred because they have to be administered frequently.
- Oral theophyllines are sometimes used for controlling chronic asthma, but their use is minimized due to side effects.
- Omalizumab, a monoclonal antibody against IgE, is a novel way to lessen exacerbations by decreasing the levels of circulating IgE that play a significant role in allergic asthma.
- Anticholinergic medications such as ipratropium bromide are not beneficial for treating chronic asthma in children over 2 years old, and are not suggested for routine treatment of chronic asthma in adults.
- There is no strong evidence to recommend chloroquine medication as a replacement for taking corticosteroids by mouth (for those who are not able to tolerate inhaled steroids). Methotrexate is not suggested as a replacement for taking corticosteroids by mouth ("steroid-sparing") due to the adverse effects associated with taking methotrexate and the minimal relief provided for asthma symptoms
- Magnesium sulfate intravenous treatment increases bronchodilation when used in addition to other treatment in moderate to severe acute asthma attacks. In adults, intravenous treatment results in a reduction of hospital admissions. Low levels of evidence suggest that inhaled (nebulized) magnesium sulfate may have a small benefit for treating acute asthma in adults. Overall, high-quality evidence do not indicate a large benefit for combining magnesium sulfate with standard inhaled treatments for adults with asthma.
- Heliox, a mixture of helium and oxygen, may also be considered in severe unresponsive cases.
- Intravenous salbutamol is not supported by available evidence and is thus used only in extreme cases.
- Methylxanthines, such as theophylline, were previously widely used in asthma management but provide little additional benefit over inhaled β-agonists and are no longer recommended, particularly in acute exacerbations, because of limited efficacy and safety concerns.
- The dissociative anaesthetic ketamine is theoretically useful if intubation and mechanical ventilation is needed in people who are approaching respiratory arrest; however, there is no evidence from clinical trials to support this. A 2012 Cochrane review found no significant benefit from the use of ketamine in severe acute asthma in children
I have never seen an article list so many unused or ineffective treatments and almost none of these appear in recent guidelines. Is there any use trying to track down recent sources for these and including them or can they just be dropped? IntentionallyDense (Contribs) 18:20, 17 December 2025 (UTC)
- @IntentionallyDense, I suggest just dropping them.
- If a suitable source falls into your lap, it might be nice to reduce outdated treatments to a single mention or the history section. For example, I know almost nothing about asthma treatment, but I recognize theophylline because it's a classic example of narrow therapeutic index (and because chocolate!), so I could imagine a sentence that mentions/links it in a list of outdated or unpopular treatments.
- The only question in my mind is whether these are all outdated in a global sense, or if some of them are still used in low-resource settings. WhatamIdoing (talk) 18:05, 19 December 2025 (UTC)
- From my understanding (and I haven't done a deep dive into the economics of asthma yet) the main outdated treatment commonly used in low resource settings is only prescribing a short acting rescue inhaler instead of a maintenance inhaled corticosteroid since its cheaper in the short term to prescribe an inhaler that will maybe used a couple times a week vs daily (ignoring the risk of exacerbation that is). However I will read through some articles on the economics of the condition before trimming to make sure that nothing should be moved to a different section. Thank you. IntentionallyDense (Contribs) 19:11, 19 December 2025 (UTC)
- This source has some outdated information on developing countries. It sounds like Salbutamol/albuterol was the normal thing to do, even in poor countries. WhatamIdoing (talk) 05:00, 21 December 2025 (UTC)
- interesting, thank you. i think the easiest thing to do would be to reformat the history section to be more cohesive (as in seperated based on topic not years) and then add truly outdated treatments to that section as well as maybe some of the outdated classification schemes. IntentionallyDense (Contribs) 08:01, 21 December 2025 (UTC)
- That sounds plausible, though I'd like to limit that information. IMO a few examples would be better than a laundry list of every single past treatment. WhatamIdoing (talk) 11:22, 21 December 2025 (UTC)
- I definitely agree. IntentionallyDense (Contribs) 15:52, 23 December 2025 (UTC)
- That sounds plausible, though I'd like to limit that information. IMO a few examples would be better than a laundry list of every single past treatment. WhatamIdoing (talk) 11:22, 21 December 2025 (UTC)
- interesting, thank you. i think the easiest thing to do would be to reformat the history section to be more cohesive (as in seperated based on topic not years) and then add truly outdated treatments to that section as well as maybe some of the outdated classification schemes. IntentionallyDense (Contribs) 08:01, 21 December 2025 (UTC)
- This source has some outdated information on developing countries. It sounds like Salbutamol/albuterol was the normal thing to do, even in poor countries. WhatamIdoing (talk) 05:00, 21 December 2025 (UTC)
- From my understanding (and I haven't done a deep dive into the economics of asthma yet) the main outdated treatment commonly used in low resource settings is only prescribing a short acting rescue inhaler instead of a maintenance inhaled corticosteroid since its cheaper in the short term to prescribe an inhaler that will maybe used a couple times a week vs daily (ignoring the risk of exacerbation that is). However I will read through some articles on the economics of the condition before trimming to make sure that nothing should be moved to a different section. Thank you. IntentionallyDense (Contribs) 19:11, 19 December 2025 (UTC)