Asthma treatment has changed significantly in recent years. SMART therapy is an approach that uses one specific type of combination inhaler for both daily asthma control and symptom relief. The inhaler contains an inhaled corticosteroid (ICS) to treat airway inflammation and formoterol, a bronchodilator that works quickly enough to relieve symptoms while also providing longer-lasting bronchodilation. For appropriate patients, SMART therapy can simplify treatment and reduce the risk of asthma exacerbations. Just as importantly, it provides anti-inflammatory medication at the time symptoms are occurring, rather than treating bronchospasm alone.
SMART stands for Single Maintenance and Reliever Therapy. It uses a single inhaler containing an inhaled corticosteroid (ICS) together with formoterol. The ICS treats the airway inflammation that is central to asthma, while formoterol relaxes the muscles surrounding the airways and works rapidly enough to provide symptom relief. The same ICS-formoterol inhaler is used as the patient’s regular maintenance treatment and, when needed, for additional symptom relief. This differs from the traditional approach in which a patient uses one inhaler every day for prevention and a separate albuterol-only inhaler for rescue. Not every combination asthma inhaler can be used for SMART therapy. Formoterol is important because it has a rapid onset of bronchodilation. The appropriate inhaler, maintenance dose, and maximum number of as-needed doses should be prescribed individually.
SMART therapy may be appropriate for many patients who need regular controller treatment, particularly those who have had asthma exacerbations or remain inadequately controlled. Whether SMART is the best strategy depends on the patient’s age, symptoms, exacerbation history, current medications, inhaler technique, and overall level of asthma control. An evaluation may be particularly helpful for patients who:
The Allergy and Asthma Clinic accepts most major insurance plans for SMART therapy, including Aetna, Anthem, Blue Cross Blue Shield, Cigna, UnitedHealthcare, UMR, Guardian, Health Net, Medicare, Great-West Healthcare, MultiPlan, PHCS, SEQUOIA, and TRICARE.
No. Airsupra is not SMART therapy, but it is based on a related treatment concept. Airsupra contains albuterol, which quickly opens narrowed airways, and budesonide, an inhaled corticosteroid (ICS) that treats airway inflammation. This means that when Airsupra is used for asthma symptoms, the patient receives treatment for both bronchospasm and inflammation rather than bronchodilation alone.
SMART therapy also treats both bronchospasm and inflammation, but it uses an ICS-formoterol inhaler. In SMART therapy, the same ICS-formoterol inhaler is used for both daily maintenance treatment and as-needed symptom relief.
Airsupra is used as an as-needed rescue inhaler, not as the daily maintenance inhaler, so it is not considered SMART therapy. Which approach is most appropriate depends on factors such as asthma severity, current medications, history of asthma attacks, and how well the asthma is controlled.
The terms are closely related. SMART stands for Single Maintenance and Reliever Therapy. International asthma guidelines commonly use the term MART, meaning Maintenance and Reliever Therapy. Both describe using an appropriate ICS-formoterol inhaler for maintenance treatment and symptom relief.
SMART therapy can be appropriate for some children and adolescents, but the recommended inhaler, dose, and age range depend on the individual patient and the treatment guideline being followed. A pediatric asthma regimen should be selected and monitored by a clinician familiar with the child’s asthma history and inhaler use.
Follow the dosing instructions provided with your treatment plan. If you are frequently missing maintenance doses or are unsure how to use the inhaler after a missed dose, contact your clinician rather than changing the regimen on your own.
Yes, some patients need additional asthma treatment. However, medications should be reviewed carefully so that bronchodilators and inhaled corticosteroids are not unintentionally duplicated and the overall regimen remains safe and understandable.
In SMART therapy, the prescribed ICS-formoterol inhaler is used for symptom relief as well as maintenance treatment. Whether you should also carry or use a separate albuterol inhaler depends on your individual treatment plan and should be clarified with your clinician.
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First and foremost let me start by saying that these people did one hell of a job figuring out my sinus problems. When I first arrived there, I explained what was going on with me having excessive inflammation in the sinus…after they tested me, I found out that I was being exposed to dust mites which gave me a strong reaction. I followed the doctors guides lines in terms of cleaning my room and ever since, my sinus inflammation went away for good and now I have a healthy sinus. Thank you for everything.
My 10 year old son also has allergies and asthma and the staff makes sure that he feels well taken care of and comfortable, despite his having Autism and ADHD. He actually looks forward to going there with me, whether it be for my allergy shots or even when he needed allergy skin testing. When you’re a patient at the Allergy and Asthma clinic, you are treated as if you are the only patient they have, even when the waiting room is full. Dr. Engler has hired truly excellent staff, from the front desk people to the nurses and medical assistants. If you have allergies and/or asthma and you live on the Peninsula or even in the city, I highly recommend that you visit the Allergy and Asthma Clinic. They are truly amazing and will make you feel so much better.
