Asthma affects about 25 million individuals worldwide and is becoming increasingly common. The entire yearly cost of asthma in the United States between 2008 and 2013, including medical care, absenteeism, and mortality, was $81.9 billion, according to a report from the Centers for Disease Control and Prevention (CDC). Despite the fact that the National Institute of Health recommends fixed inhaled corticosteroid (ICS) dose, the 2008–2010 Medical Expenditure Panel Survey found that asthma has remained inadequately managed. A suggested alternate management method is single inhaler maintenance and reliever therapy (SMART). This article compares SMART goals to current treatment guidelines. SMART uses symptom-driven ICS dosing to treat fluctuating inflammation. It employs a combination inhaler containing a long-acting -agonist with an instantaneous onset of action to provide instant relief, in conjunction with an ICS. According to recent research, SMART reduces the frequency and severity of asthma exacerbations when compared to fixed ICS dose. Furthermore, irregular use of ICS had a smaller effect on growth and allowed for a lower overall amount of ICS to be supplied.

SMART appears to outperform treatment that is based on current US standards. Because SMART-capable inhalers are already approved, the Food and Drug Administration must approve the SMART strategy.

Reference: https://journals.lww.com/co-allergy/Abstract/2019/04000/Single_inhaler_maintenance_and_reliever_therapy_in.7.aspx