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What is Symbicort SMART®?
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| 1. What is Symbicort maintenance and reliever therapy? |
| Symbicort SMART® is Maintenance And Reliever Therapy in one inhaler, a separate reliever is not required. |
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| Symbicort SMART® |
| Symbicort® Maintenance And Reliever Therapy in ONE inhaler |
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| Symbicort SMART® treats the underlying inflammation with every inhalation, whether used for maintenance ore relief. |
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| Symbicort SMART® treats the inflamation with every inhalation, wheather used for maintenance or relief |
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Symbicort Maintenance and Reliever Therapy (SMART) is a new approach to asthma management. This new approach in asthma management is possible due to;
1. the formoterol component, a long-acting b-agonist (LABA) bronchodilator that also has a fast onset of action, as fast as short-acting b-agonists (SABAs) (Boonsawat et al 2003; Balanag et al 2006; Ringdal et al 1998; Ketchell et al, 2002; Seberova et al 2000)
Read more about formoterol
2. The inhaled corticosteroid component of Symbicort, budesonide, addresses the underlying inflammation that is characteristic of asthma. Dose-response studies have shown that inhaled budesonide significantly improves lung function and reduces exacerbations.
Higher doses of budesonide provide further dose-dependent improvements in lung function at doses up to 800 µg twice daily (Busse et al 1998). In fact, increasing both the dose and the frequency of ICS administration is beneficial in asthma that is poorly controlled (Toogood et al 1982).
It has also been shown that temporarily increasing the dose of budesonide at the first sign of worsening asthma effectively manages an exacerbation as well as regular higher doses of budesonide (Foresi et al 2000).
This study showed that once asthma was under control, a low dose of budesonide was as effective as a fixed moderate dose for maintaining asthma control, provided this dose was increased (both total dose and frequency) at the first sign of a worsening in asthma control.
Read more about budesonide
In addition to the maintenance doses taken for day-to-day asthma control, Symbicort is also used as needed if symptoms occur, to provide both rapid relief and increased asthma control.
Clinical studies show that this is a more effective way to treat asthma; patients using Symbicort SMART experience fewer daily symptoms, experience less night-time awakenings and have fewer severe exacerbations compared with ‘traditional’ fixed-dose ICS/LABA therapy plus as needed SABA (O’Byrne et al 2005; Rabe et al 2006).
The reduction in exacerbations seen with Symbicort SMART suggests that a crucial factor might be related to the timing of the ICS dose. After inhalation of ICS, lung tissue concentrations decline over time. Therefore, ICS taken as needed might supplement the tissue concentrations of ICS at a time when the concentration of ICS remaining from the scheduled maintenance dose is suboptimal (Rabe et al 2006a).
Finally, combining an appropriate maintenance dose of formoterol with budesonide reduces the incidence of severe asthma exacerbations more effectively than increasing the ICS dose alone (Pauwels et al 1997).
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| 2. What are the most likely benefits of Symbicort SMART® for my patients? |
Symbicort SMART is a more effective way to treat asthma compared with higher doses of ICS or a combination product of an ICS/LABA, both using a separate SABA inhaler for relief.
This new approach to treatment:
- Improves daily asthma control by reducing the incidence of asthma symptoms and the need for as needed reliever therapy (O’Byrne et al 2005; Rabe et al 2006; Vogelmeier et al 2005; Scicchitano et al 2004).
- Reduces the incidence of asthma exacerbations and the use of oral steroids (Kuna et al 2007; O’Byrne et al 2005; Rabe et al 2006a,b; Vogelmeier et al 2005; Scicchitano et al 2004).
- Reduces exacerbations leading to hospitalisations and emergency room visits (Rabe et al 2006a,b).
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