BRONCHIAL ASTHMA: CLINICAL MANAGEMENT AND THERAPY WITH FOCUS ON CENTRAL ASIA AND KYRGYZSTAN —A RECENT EVIDENCE-BASED REVIEW

Asthma is a heterogeneous chronic inflammatory disease of the airways that remains a major cause of morbidity and health-system use worldwide.Recent global strategies prioritize inhaled corticosteroid (ICS)containing regimens for both maintenance and reliever therapy and recommend phenotype-directed escalation, including biologic agents for severe disease.Low-and middle-income countries (LMICs), including Central Asia, face specific implementation barriers: underdiagnosis, limited spirometry use, poor access to ICS and combination inhaler formulations, and cost-driven non-adherence.Country-specific research from Kyrgyzstan is limited, but recent regional studies report high symptom prevalence among children and point to gaps between measured prevalence and official registry figures.Evidence from randomized trials and highquality reviews supports ICS-formoterol as the preferred controller-reliever strategy, and growing evidence shows the efficacy of biologics (anti-IgE, anti-IL-5/IL-5R, anti-IL-4Rα, and anti-TSLP) in severe asthma.However, in Kyrgyzstan and much of Central Asia, constrained medication availability, medicine pricing, and limited specialist services restrict uptake of modern approaches.This review synthesizes recent (last decade) international guidance and trials and regional studies, highlights implementation bottlenecks in Kyrgyzstan, and offers pragmatic clinical and policy recommendations to optimize asthma therapy in the Central Asian setting.(Global Initiative for Asthma -GINA)