What is budesonide/formoterol (Symbicort®) SMART® dosing?
Budesonide/formoterol SMART® (Symbicort for Maintenance And Reliever Therapy) dosing is a new approach to the management of moderate to severe asthma, and should not be confused with the SMART RCT discussed earlier. It involves the use of a single budesonide/formoterol combination inhaler as both maintenance and reliever treatment for adults aged >18 years. Is there evidence to support its use? There is evidence that budesonide/formoterol SMART® dosing may be more effective at reducing exacerbation rates in people with moderate to severe asthma symptoms compared with conventional methods.24-26 See Table 2 for a summary of the evidence and recommendations. The key trials with budesonide/formoterol SMART® dosing included patients who were not typical of most people managed in primary care: • all were at step 3 or 4 of BTS/SIGN and had experienced one or more severe exacerbation in the previous 12 months24-27 • in trials comparing SMART® with fixed dose budesonide/formoterol or higher dos
