Summary: The paradigm of asthma management is described by he GINA guidelines which are based on multicenter randomized clinical trials. However, advances of medical sciences result in the evolution of guidelines and changes in clinical practice. Patients with asthma are often noncompliant with the prescription of inhaled corticosteroids (ICS). Possible reasons may include paradoxes in the GINA guidelines, among them: monotherapy with short-acting bronchodilators (SABA) in the first step of treatment despite the inflammatory background of asthma, getting patients accustomed to the fact that inhalers should bring immediate relief and afterwards requiring them to take only ICS daily and providing them with contradictory information concerning the safety of bronchodilators in asthma. To overcome these paradoxes, several clinical trials on rescue and intermittent administration of ICS/LABA have been performed in recent years, among them two large trials: SYGMA 1 and SYGMA 2 published very recently. It was revealed that BUD/FOR as a rescue treatment was non-inferior with regard to frequency of exacerbations to maintenance treatment with BUD but not as effective as BUD in the number of weeks with well controlled asthma. It seems reasonable to expect a treatment update in step 1 and 2 in the GINA guidelines in the nearest future.