A 28-year-old woman with persistent asthma reports daytime symptoms 4 days per week and nighttime awakenings twice monthly. She currently uses low-dose budesonide-formoterol as needed. According to GINA 2023 guidelines, what is the recommended step-up in therapy?
- A Add a separate LABA to her current ICS
- B Add oral montelukast 10 mg daily
- C Switch to low-dose ICS-formoterol as maintenance and reliever therapy (MART) ✓
- D Increase to high-dose ICS with a separate LABA
Correct answer: C. Switch to low-dose ICS-formoterol as maintenance and reliever therapy (MART)
Explanation
GINA 2023 recommends for Step 3, low-dose ICS-formoterol as maintenance and reliever therapy (MART) as the preferred controller. This reduces exacerbation risk compared with same-dose ICS-LABA plus SABA reliever. Adding a separate LABA to ICS without maintenance dosing is not the preferred step-up strategy.
Reference: Global Initiative for Asthma (GINA) Report, 2023 ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.