From the Guidelines
MART (Medical Asthma Regimen/Treatment) refers to Maintenance and Reliever Therapy, a simplified approach to asthma management that uses a single inhaler containing both a corticosteroid (for long-term control) and a fast-acting bronchodilator (for quick relief). The most common MART combinations include budesonide-formoterol (Symbicort) or beclomethasone-formoterol (Foster) 1. Patients typically take 1-2 puffs daily as maintenance and additional puffs as needed for symptom relief, up to a maximum daily dose (usually 8-12 puffs depending on the specific medication). This approach works because it addresses both underlying inflammation and acute symptoms simultaneously, increasing anti-inflammatory medication when symptoms worsen.
Key Points
- MART simplifies treatment by eliminating the need for separate maintenance and rescue inhalers, improves compliance, and has been shown to reduce severe exacerbations compared to traditional regimens 1.
- It's particularly beneficial for patients with moderate to severe asthma who experience fluctuating symptoms.
- Patients should be properly instructed on inhaler technique and understand when to seek medical attention if symptoms aren't controlled with this approach.
Mechanism of Action
- Inhaled corticosteroids (ICSs) are the most consistently effective long-term control medication at all steps of care for persistent asthma, and ICSs improve asthma control more effectively in both children and adults than leukotriene receptor antagonists (LTRAs) or any other single, long-term control medication do 1.
- Long-acting b2-agonists (LABAs) are inhaled bronchodilators that have a duration of bronchodilation of at least 12 hours after a single dose, and are used in combination with ICSs for long-term control and prevention of symptoms in moderate or severe persistent asthma 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Definition of MART
- MART stands for Medical Asthma Regimen/Treatment, also known as Maintenance and Reliever Therapy 2, 3
- It is a treatment approach that uses a single inhaler containing a combination of an inhaled corticosteroid (ICS) and a long-acting beta 2-adrenergic bronchodilator (LABA) for both maintenance and reliever therapy 2, 4, 3
Components of MART
- Inhaled corticosteroids (ICS) are the most potent and effective anti-inflammatory agents for the treatment of asthma 5
- Long-acting beta 2-adrenergic bronchodilators (LABA) are used in combination with ICS to improve pulmonary function and reduce symptoms 5, 4
- Formoterol is a specific LABA that is commonly used in MART 2, 4, 3
Benefits of MART
- Improves asthma control and reduces exacerbations 2, 4, 3
- Simplifies management and improves adherence to treatment 2, 3
- Reduces the need for supplemental use of short-acting beta 2-adrenergic bronchodilators 5
- Provides a lower overall exposure to ICS 4