New asthma guidelines update. The National Heart, Lung, and Blood Advisory Council has published updates to the National Asthma Education and Prevention Program guidelines for the management of asthma in adolescents and adults in the December 8, 2020, issue of JAMA. A major change in the guidelines is the recommendation for use of an inhaled corticosteroid (ICS) on an as-needed basis for patients with mild or moderate persistent asthma. The new guidelines recommend treating patients who have mild persistent asthma with either a daily ICS supplemented with a short-acting [beta]-2 agonist (SABA) for symptom relief or both an ICS and a SABA for symptoms as needed. For moderate persistent asthma, the new guidelines recommend single maintenance and reliever therapy, known as SMART, using an ICS combined in a single inhaler with formoterol, a long-acting [beta]-2 agonist, daily for maintenance, with additional doses as needed.