Population-Based Single Maintenance and Reliever Therapy (SMART) Recommendations
| Guideline | Patient Population | ||||
|---|---|---|---|---|---|
| Age (Years) | ACO | EIB | |||
| 0 to 5 | 6 to 11 | ≥12 | |||
| GINA5(2022) | Not indicated | Initiate SMART at Steps 3 & 4 | Initiate SMART at Steps 3 & 4 | Refer to patient age | None |
| 0 to 4 | 5 to 11 | ≥12 | ACO | EIB | |
|---|---|---|---|---|---|
| NAEPP6 (2020) | Not indicated | Initiate SMART at Steps 3 & 4 May continue ICS+SABA therapy if patient is well controlled | Initiate SMART at Steps 3 & 4 May continue ICS+SABA therapy if patient is well controlled | None | None |
ICS-formoterol is the preferred reliever medication in GINA Steps 1 or 2 for patients older than 12 years old and may be used to reduce exercise-induced bronchoconstriction when used as needed.
Abbreviations: GINA, Global Initiative for Asthma; NAEPP, National Asthma Education and Prevention Program; ACO, Asthma/COPD Overlap; EIB, Exercise-Induced Bronchoconstriction; SMART, Single Maintenance and Reliever Therapy; ICS-SABA, ICS monotherapy plus short-acting b-agonists.