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

Pediatric asthma is a prevalent chronic respiratory condition requiring effective management strategies to prevent exacerbations and improve long-term outcomes. Inhaled corticosteroids (ICS) remain the foundation of asthma control, often combined with long-acting beta-2 agonists (LABAs) to enhance symptom relief. However, adherence challenges with separate maintenance and reliever inhalers have led to the emergence of maintenance and reliever therapy (MART) as an alternative approach. MART combines ICS and formoterol into a single inhaler for both maintenance and symptom relief, simplifying treatment regimens and ensuring consistent anti-inflammatory therapy. Recent studies demonstrate that MART reduces exacerbations, improves asthma control, and enhances adherence, compared with traditional ICS-LABA therapy. However, concerns remain regarding its long-term safety, potential overuse, and effects on growth and development. This review explores the rationale, clinical efficacy, and special considerations for MART in pediatric asthma, emphasizing the need for further research to refine its role in individualized treatment strategies.