A 35-year-old woman with moderate persistent asthma (Step 3, GINA guidelines) has daytime symptoms 4 days/week, nighttime awakenings twice monthly, and post-bronchodilator FEV1 78% predicted. She is currently on low-dose ICS-LABA as maintenance plus as-needed SABA. According to GINA 2023, which is the preferred Step 3 controller regimen for her?
- A Low-dose ICS plus long-acting muscarinic antagonist (LAMA)
- B Medium-dose ICS plus as-needed SABA
- C Low-dose ICS-formoterol as maintenance and reliever therapy (MART) ✓
- D High-dose ICS-LABA plus as-needed SABA
Correct answer: C. Low-dose ICS-formoterol as maintenance and reliever therapy (MART)
Explanation
GINA 2023 recommends low-dose ICS-formoterol as maintenance and reliever therapy (MART) as the preferred Step 3 option for adults/adolescents. MART uses the same inhaler for both maintenance and as-needed relief, replacing SABA-only reliever. This reduces severe exacerbation risk compared with SABA reliever. Medium-dose ICS is an alternative, not preferred. LAMA add-on is Step 4-5. High-dose ICS-LABA is Step 4-5 for uncontrolled patients.
Reference: GINA 2023 Guidelines (Global Strategy for Asthma Management and Prevention)
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.