Maintenance and Reliever Therapy in Pediatric Asthma: A Concise Review of Recent Evidence-Part I.

Abstract

Pediatric asthma is a chronic inflammatory respiratory condition characterized by recurrent wheezing, chest tightness, breathlessness, and coughing, which can significantly impact quality of life and lead to hospitalization or long-term lung impairment. The prevalence of asthma has increased globally, with higher rates in urban areas and developing countries. Current management strategies emphasize inhaled corticosteroids (ICS) as the cornerstone of treatment, with long-acting beta 2-agonists (LABAs) introduced for patients requiring additional symptom control. ICS-LABA combinations have demonstrated efficacy in reducing exacerbations, improving lung function, and lowering health care utilization. However, concerns persist regarding adherence, potential masking of airway inflammation, and optimal dosing. The emerging maintenance and reliever therapy (MART) approach integrates ICS and formoterol into a single inhaler for both maintenance and symptom relief, aiming to enhance adherence and optimize treatment outcomes. This review examines the current evidence supporting ICS-LABA therapy and introduces MART as a potential alternative for pediatric asthma management.