Single maintenance and reliever therapy in treatment of asthma exacerbations

To evaluate the effectiveness and practicality of single maintenance and reliever therapy (SMART) in the treatment of asthma exacerbation.PubMed, MEDLINE, Cochrane, and Clinical Trial databases using the keywords SMART therapy, maintenance and reliever therapy, and budesonide and formoterol.Articles were selected based on their relevance and applicability to this topic.Multiple studies have evaluated the efficacy of SMART in reducing asthma exacerbations in comparison to standard inhaled corticosteroid maintenance and short-acting beta-agonist rescue therapy. Most of the randomized trials demonstrated a reduction in asthma exacerbation with open-label studies revealing similar effectiveness in reducing asthma exacerbation. Previously, concerns have been raised regarding the administration of increased doses of long-acting beta-agonist that may potentially mask symptoms and delay appropriate medical attention. However, studies have not demonstrated an increase in morbidity or mortality. The primary concern regarding many of these trials is that they have been sponsored by pharmaceutical companies.Although not all studies demonstrated the effectiveness of SMART, most revealed a substantial reduction in asthma exacerbation frequency and severity.