Poor Sakura Vol 1 4 [PATCHED]
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SMART is a combination of a LABA and ICS that is delivered via a dry powder inhaler and has been recommended in several international guidelines for patients with moderate to severe asthma (1). Several trials have evaluated the risk of severe asthma exacerbations associated with SMART compared with LABA plus ICS in patients with poorly controlled asthma (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17). However, the results of these trials have been inconsistent. Six trials (2, 3, 4, 6, 7, 10) showed a significant reduction in severe exacerbations with SMART compared with LABA plus ICS (P =.04 to.01). One trial (5) showed a reduced number of exacerbations with SMART (P =.01), whereas another trial (8) showed no significant difference between the two treatment groups (P =.79). In contrast, two trials (3, 14) showed no significant difference between the SMART and LABA plus ICS groups (P =.11 and P =.26). Three trials (4, 5, 9) had insufficient power to assess the risk of severe asthma exacerbations (P =.29,.01, and.77). The risk of severe asthma exacerbations was significantly decreased in two trials (13, 17) that assessed the risk of hospitalization (P =.02 and P 827ec27edc