Elendu Chukwuka, Amaechi Dependable C, Elendu Tochi C, Amaechi Emmanuel C, Elendu Ijeoma D, Joseph Mary C, Ajakaye Abolore Aminat, Ansong Sandra O, Tyagi Varun, Anukam Lordsfavour I, Oguoma Chiamaka O
Department of Medicine, Federal University Teaching Hospital, Owerri, Nigeria.
Department of Medicine, Igbinedion University, Okada, Nigeria.
Ann Med Surg (Lond). 2025 Jul 16;87(8):5153-5164. doi: 10.1097/MS9.0000000000003491. eCollection 2025 Aug.
Our review examined recent evidence on asthma management, focusing on updated clinical guidelines, pharmacologic and non-pharmacologic treatment strategies, and population-specific considerations. Particular attention was given to the Global Initiative for Asthma and the National Heart, Lung, and Blood Institute guidelines.
We included peer-reviewed articles, clinical guidelines, systematic reviews, meta-analyses, randomized controlled trials, and cohort studies published in English from January 2018 to August 2024. Studies not focused on asthma management published before 2018 that were not in English or lacked relevant clinical content were excluded. Literature was identified via PubMed, Embase, Scopus, and the Cochrane Library searches. The GRADE framework assessed evidence quality across study design, consistency, and applicability. Due to heterogeneity in study designs and outcomes, a narrative synthesis was conducted.
Sixty-two studies met inclusion criteria, including clinical guidelines ( = 4), systematic reviews/meta-analyses ( = 14), randomized controlled trials ( = 18), cohort studies ( = 11), and expert reviews ( = 15). These addressed pharmacologic therapy, biologics, digital health tools, and care in specific populations. High-certainty evidence supports inhaled corticosteroid-based stepwise therapy and biologics for severe asthma. Moderate-certainty evidence supports digital tools and lifestyle interventions, while alternative therapies have low-certainty support. Biologics like dupilumab and benralizumab showed consistent reductions in severe asthma exacerbations.
Evidence was limited by heterogeneity, potential bias in lower-quality studies, and inconsistent outcome reporting. Findings affirm guideline-based therapy as foundational while highlighting the growing role of biologics and digital innovations.
Our review received no external funding and was not registered in a systematic review registry.
我们的综述考察了哮喘管理的最新证据，重点关注更新后的临床指南、药物和非药物治疗策略以及特定人群的考量因素。特别关注了全球哮喘防治创议（Global Initiative for Asthma）和美国国立心肺血液研究所（National Heart, Lung, and Blood Institute）的指南。
我们纳入了2018年1月至2024年8月以英文发表的同行评议文章、临床指南、系统评价、荟萃分析、随机对照试验和队列研究。排除2018年之前发表的非英文且未聚焦于哮喘管理或缺乏相关临床内容的研究。通过PubMed、Embase、Scopus和Cochrane图书馆检索来识别文献。GRADE框架评估了研究设计、一致性和适用性方面的证据质量。由于研究设计和结果存在异质性，因此进行了叙述性综合分析。
62项研究符合纳入标准，包括临床指南（n = 4）、系统评价/荟萃分析（n = 14）、随机对照试验（n = 18）、队列研究（n = 11）和专家综述（n = 15）。这些研究涉及药物治疗、生物制剂、数字健康工具以及特定人群的护理。高确定性证据支持基于吸入性糖皮质激素的阶梯式治疗和用于重度哮喘的生物制剂。中等确定性证据支持数字工具和生活方式干预，而替代疗法的证据支持力度较低。度普利尤单抗和贝那利珠单抗等生物制剂显示出重度哮喘急性加重的持续减少。
证据受到异质性、低质量研究中的潜在偏倚以及结果报告不一致的限制。研究结果肯定了基于指南的治疗作为基础，同时突出了生物制剂和数字创新日益增长的作用。
我们的综述未获得外部资金支持，也未在系统评价注册库中注册。
