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Tuesday, February 2, 2010

Symbicort as a rescue inhaler

Last week I wrote about how I think that Advair and Symbicort get a bad rap due to fears that the long-acting bronchodilators in them (Serevent and Formeterol) have been linked to asthma deaths. Yet, in U.K., scientists have found Symbicort to be safe enough to approve it to be used not just as a preventative medicine, but as a rescue inhaler too.

It's called the SMART program, and you can read about it by clicking here.

According to, SMART is an acronym for "Symbicort Maintenance And Reliever Therapy." The SMART program is explained here:

"It is a daily asthma management approach that allows you to use a single Symbicort inhaler as both a preventer and a reliever. Currently Symbicort is the only medication available for use as BOTH a maintenance preventer and reliever.

SMART works this way as it contains 2 different types of medicine in the same inhaler – a preventer (Pulmicort [Budesonide]) as the long acting reliever which helps to control redness and swelling in the airways, and a reliever (Oxis [Eformoterol]) which can not only work quickly, but can also last a long time.

A person using the SMART approach to manage their asthma would take a maintenance dose of Symbicort, usually morning and night to maintain or establish asthma control AND they would also take additional inhalations of Symbicort as needed to relieve symptoms.

SMART is suitable for all people aged 12 years or older who are currently recommended to take combination medication for their asthma.
You can see that so long as the long-acting bronchodilator is deemed as safe to be used more than twice a day, it provides the patient with an extra dose of steroid each time a rescue inhaler is used. This basically allows the patient to increase his corticosteroid when he's having trouble with his asthma, and decrease it when he's doing well. In this way the asthmatic has more control

Thus, "Studies have shown that people using Symbicort SMART – an additional way of taking the existing Symbicort inhaler - took no extra inhaled steroids and needed fewer oral steroids compared to traditional treatment methods. They also experienced fewer asthma attacks."

An Astra Zeneca sponsored study (the makers of Symbicort) noted the SMART program resulted in a 28% reduction in severe exacerbation compared to a regimine of using Symbicort twice a day while using something like Ventolin as a rescue inhaler in between.

The use of Symbicort in this manner in the U.S. is presently being reviewed by researchers.

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