Download SMART-MART Regimen in asthma

November 2013
The use of Symbicort® (budesonide/formoterol) and Fostair®
(beclometasone/formoterol) as regular maintenance and
reliever treatment in asthma as per the SMART/MART
regimens
The Interface Prescribing and New Therapies Subgroup discussed the
above at its meeting on the 19th November 2013. The recommendation of
this subgroup is as follows:*
The Interface Prescribing & New Therapies Subgroup of the GMMMG
considered the use of Symbicort® (budesonide/formoterol) and Fostair®
(beclometasone/formoterol) as regular maintenance and reliever treatment as
per the SMART/MART regimens.
The group recommends that both Symbicort® and Fostair® can be used
as a treatment option for selected adults at step 3 whose asthma is
poorly controlled or for selected adults at step 2 whose asthma is poorly
controlled and are taking more than 400 mcg per day of beclometasone
dipropionate or equivalent each day.
The use of budesonide or beclometasone/formoterol in a single inhaler as
rescue medication instead of a short-acting β2-agonist, in addition to its
regular use as controller therapy has been shown to be an effective treatment
regime and may reduce the risk of exacerbations in these patients.
Careful education of patients about the specific issues around this
management strategy is required. This should include advice on maximum
doses and action if lack of response.
Patients taking rescue ICS/LABA once a day or more on a regular basis
should have their treatment reviewed.
The group reminds prescribers that both these regimens are NOT licensed for
patients <18 years.
Review date: November 2015
* Unless superseded by NICE guidance or substantial and significant new evidence becomes available.
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