A New Treatment Strategy for Asthma : SMART (Symbicort® Maintenance And Reliever Therapy)

Article information

J Korean Med Assoc. 2007;50(3):279-283

Publication date (electronic) : 2007 March 31

doi : https://doi.org/10.5124/jkma.2007.50.3.279

Department of Internal Medicine, Ajou University College of Medicine, Korea. hspark@madang.ajou.ac.kr, ye9007@hanmail.net

Abstract

Asthma is characterized by chronic inflammation of the airways with variable airflow limitation resulting in recurrent wheezing, chest tightness, and cough. Long term management is essential to prevent symptom and asthma exacerbation with using daily controller medications. Asthma control was much improved by combining inhaled corticosteroids with long-acting β2 agonists. Recent several studies demonstrated the effectiveness of a new asthma management strategy, a single inhaler containing budesonide and formoterol for both maintenance therapy and symptom relief (called SMART) which was approved in GINA guideline, 2006. This SMART strategy could reduce the frequency of severe exacerbations and the need for rescue medicine with systemic steroids as well as improved lung function and asthma controls at relatively lower doses of corticosteroid with lesser costs for treatment.

Keywords: Asthma; ICS and LABA combination; SMART

References

1. National Institutes of Health: National Heart, Lung, and Blood Institute. Global strategy for asthma management and prevention. Global Initiative for Asthma Bethesda, MD: National Institutes of Health; Revised 2006.

2. Cho SH, Park HW, Rosenberg DM. The current status of asthma in Korea. J Korean Med Sci 2006. 21181–187.

3. Cho SH, Kim YK, Chang YS, Kim SS, Min KU, Kim YY. Asthma insights and reality in Korea. Korean J Medicine 2006. 7069–76.

4. O'Byrne PM, Bisgaard H, Godard PP, Pistolesi M, Palmqvist M, Zhu Y, Ekström T, Bateman ED. Budesonide/Formoterol combination therapy as both maintenance and reliever medication in asthma. Am J Respir Crit Care Med 2005. 171129–136.

5. Rabe KF, Pizzichini E, Ställberg B, Romero S, Balanzat AM, Atienza T, Atienza T, Lier PA, Jorup C. Budesonide/Formoterol in a single inhaler for maintenance and relief in mild-to-moderate asthma: A randomized, double-blind trial. Chest 2006. 129246–256.

6. Johansson G, Andreasson EB, Larsson PE, Vogelmeier CF. Cost effectiveness of Budesonide/Formoterol for maintenance and reliever therapy versus Salmeterol/Fluticasone plus Salbutamol in the treatment of asthma. Pharmacoeconomics 2006. 24695–708.

Article information Continued

Table 1

Management approach based on control (GINA, 2006)