Anti-inflammatory reliever (AIR) and Maintenance and Reliever Therapy (MART) for Asthma

What is it?

Anti-Inflammatory Reliever (AIR) and Maintenance and Reliever Therapy (MART) are modern approaches to asthma management that uses a SINGLE inhaler combining two medications:
 
  • Inhaled steroid: This medication reduces inflammation in your airways, addressing the root cause of asthma symptoms.
  • Formoterol: A fast-acting reliever that quickly opens up your airways during asthma symptoms or attacks.
This combination allows you to manage both the underlying inflammation and the immediate symptoms with ONE inhaler. 
 
AIR therapy is when you use this combination inhaler as required to relieve your symptoms, in the same way that you may have previously used your salbutamol/Ventolin rescue inhaler. 
 
MART is when you use this inhaler every day to prevent your asthma symptoms from happening, and as a top-up reliever for fast relief of asthma symptoms when required.
 
Who is recommended AIR therapy?
 
If you only get asthma symptoms occasionally, we may prescribe you an AIR inhaler, to use only when you need to. For example, if:
  • You only get asthma symptoms occasionally (less than twice a month).
  • You only need help managing your asthma at certain times of the year, for example during pollen season.
  • You only need help managing your symptoms when you exercise.
Why is an anti-inflammatory reliever recommended over salbutamol alone?
 
When a person is suffering from asthma, the muscles around the walls of the airway tighten so the airways become narrower, and the lining of the airways becomes inflamed and starts to swell.
 
Traditional blue reliever inhalers (salbutamol) work by quickly relaxing the muscles around your airways, providing rapid relief from asthma symptoms. However, they don’t address the underlying inflammation that causes these symptoms. Relying solely on salbutamol can lead to overuse, which has been associated with poorer long-term asthma control and an increased risk of severe asthma attacks.
 
In contrast, AIR therapy not only provides quick relief through formoterol but also delivers an inhaled steroid to reduce inflammation.
This dual approach means that every time you use your inhaler for symptom relief, you’re also treating the underlying cause.
 
Studies have shown patients receiving AIR therapy have a 65% lower risk of hospitalisation and emergency department visits for asthma exacerbations, and a 55% lower risk of needing courses of steroid tablets, compared to those who just use salbutamol alone.
 
As a result, people who are prescribed an AIR treatment plan do not require an additional salbutamol inhaler.
 
 
What is Maintenance and Reliever Therapy (MART)?
 
Traditionally, asthma has been managed with separate inhalers: a maintenance inhaler containing a steroid for daily use, and a reliever inhaler to use when symptoms arise.
 
On a MART treatment plan, you take your inhaler every day as prescribed, as well as when you get symptoms. This is recommended for people whose asthma affects them on a more regular basis.
 
Research has shown that MART offers significant advantages over 'preventer' and 'reliever' regimens, including lower risk of severe asthma attacks. This is because MART ensures that every dose of reliever taken includes an anti-inflammatory component, leading to fewer flare-ups.
 
IMPORTANT: not all combination inhalers can be used to relieve symptoms i.e. they are not suitable for MART.  With some combination inhalers you still need to use a blue reliever inhaler if you get symptoms or have an asthma attack. Your healthcare professional will tell you if you need to do this.
 
Supporting Links
 
 

Page last reviewed: 01 October 2025
Page created: 29 September 2025