Asthma CPG revived: Key updates and advances after an 8-year hiatus

Andrea Ban Yu-Lin
Faculty of Medicine, Universiti Kebangsaan Malaysia, Hospital Canselor Tuanku Muhriz, Cheras, Kuala Lumpur, Malaysia

After an eight-year interval, the 2025 revision of Malaysia’s Clinical Practice Guidelines (CPG) on the management of asthma in adults marks a timely and transformative update, reflecting major global and local advances in asthma care. Rooted in Malaysian clinical practice while aligning with international standards, the updated CPG introduces a more patient-centred, evidence-informed approach. Key changes include the adoption of as-needed low-dose ICS-formoterol even at initial treatment steps, moving away from the outdated SABA-only approach of the 2017 guidelines. A streamlined, stepwise treatment algorithm tailored to the Malaysian healthcare system now guides clinicians in both primary and tertiary settings.

The CPG places greater emphasis on inhaler technique training, digital tools, and adherence strategies—critical components in a multiracial, multilingual population where health literacy and access vary. It also features a locally developed algorithm for selecting biologic therapies in severe asthma, reflecting Malaysia’s growing capacity for precision medicine. Expanded guidance on special groups—such as pregnant women, those with occupational exposure, and individuals living with comorbidities—acknowledges the diverse realities of Malaysian patients.

Recognising the lessons of the COVID-19 pandemic, the CPG includes initiatives for future digital tools, such as online inhaler tutorials in local languages. With an eye on implementation, it advocates for structured multidisciplinary care, improved referral pathways, and health system integration. The 2025 CPG is more than a clinical document—it is a call to action to elevate asthma care in Malaysia, reduce disparities, and empower both clinicians and patients toward better control and quality of life.