This approach allows the simultaneous use of Symbicort as maintenance and reliever therapy in adults, allowing patients to increase the dose of Symbicort when their asthma worsens and avoiding the need for multiple inhalers.
Studies have been done which support the use of Symbicort for maintenance and reliever therapy.1,2,3 Symbicort SMART significantly increased the time to first severe exacerbation and the rate of exacerbations was reduced by 45 per cent compared with fixed-dose Symbicort plus a separate short-acting reliever therapy.1 The SMART regimen also prolonged the time to first exacerbation requiring hospitalisation, emergency room treatment or oral steroids compared with fixed-dose Symbicort or salmeterol/fluticasone treatment, plus separate short-acting reliever therapy.2 In a third study3, the SMART regimen prolonged the time to first severe exacerbation and reduced the total number of severe exacerbations compared with salmeterol/fluticasone treatment plus reliever medication.
The new SMART dosing regimen applies to both the Symbicort 100/6 and 200/6 inhalers. Symbicort 400/12 is not licensed for use in this way.
1. O’Bryne P, Bisgaard H, Godard P et al. Budesonide/ formoterol combination therapy as both maintenance and reliever medication in asthma. Am J Respir Crit Care Med 2005; 171: 129–136.
2. Kuna P, Peters M, Manjra A et al. Effect of budesonide/ formoterol maintenance and reliever therapy on asthma exacerbations. Int J Clin Pract 2007; 61(5): 725–736.
3. Vogelmeier C, D’Urzo A, Pauwels R et al. Budesonide/ formoterol maintenance and reliever therapy: an effective asthma treatment option? Eur Respir J 2005; 26: 819–828.
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