Single inhaler therapy decreases frequency and intensity of asthma exacerbations: Review

USA: A recent study published in Annals of Allergy, Asthma & Immunology on July 2022 found that some of the clinical trials supported single maintenance and reliever therapy (SMART's) efficacy, on the other hand, a vast majority showed a marked decrease in the frequency and severity of asthma exacerbations.

Syed Fahmeed Imam and colleagues conducted this study in order to assess the efficacy and viability of SMARTs in the management of asthma exacerbations.

The key findings of this extensive review were as follows:

1. The effectiveness of SMART in minimizing asthma exacerbations in comparison to conventional inhaled corticosteroid (ICS) maintenance and short-acting beta-agonist (SABA) rescue therapy has been examined in several trials.

2. The majority of the randomized trials showed a decrease in asthma exacerbations, and open-label studies also showed similar benefit in this area.

3. Increased dosages of long-acting beta-agonists have previously sparked concerns due to their ability to conceal symptoms and postpone receiving proper medical care.

4. Studies, have not shown any significant rise in morbidity or death.

5. The fact that many of these trials were funded by pharmaceutical firms is the main cause for concern

In conclusion, the results of these studies show the effectiveness of SMART in reducing asthma exacerbations and improving asthma control with lower doses of ICS in comparison to fixed doses of ICS-LABA for maintenance or higher doses of ICS, both with SABA as needed, while also possibly reducing requirements for oral corticosteroids.

Nevertheless, the researchers noted that their findings were not all agreed upon despite these encouraging results. The authors ask for more studies by other groups to confirm SMART's efficacy because pharmaceutical firms support these studies as well. In order to assist patients in better adhering to SMART suggestions, the authors also noted the necessity for insurance companies to address policy adjustments.

Reference:

Imam, S. F., Zafar, S., & Oppenheimer, J. (2022). SMART in treatment of asthma exacerbations. In Annals of Allergy, Asthma & Immunology. Elsevier BV. https://doi.org/10.1016/j.anai.2022.07.024