For more than 25 years, national and international guidelines have recommended standardized approaches to control the symptoms of asthma and reduce the risk of exacerbation using strategies that are relevant to the majority of patients with asthma. 1,2 As new evidence emerges from randomized clinical trials, clinicians must modify treatment strategies to be consistent with new evidence. In this issue of JAMA, 2 JAMA Insights articles 3,4 highlight new evidence that clinicians should consider when treating patients with asthma.In one article, Tripple and colleagues 3 review new strategies in chronic asthma management that differ from the 2007 National Institutes of Health (NIH) guidelines, the Expert Panel Report-3: Guidelines for the Diagnosis and Management of Asthma, 1 and are incorporated in the 2019 Global Initiative for Asthma Global Strategy for Asthma Management and Prevention. 2 The first of these new strategies involves treatment of adolescent and adult patients with mild and intermittent asthma with a daily inhaled corticosteroid (ICS). Previously, NIH guidelines stated that as-needed inhalation of short-acting β 2 -agonists alone was sufficient treatment for these patients. 1 The rationale for the use of ICS in this setting is in part based on findings from a post hoc analysis of data from a large, multicenter clinical trial. 5 Results of the post hoc analysis showed that even patients with mild intermittent asthma were at risk of severe asthma-related adverse events (a composite outcome of hospitalization, emergency care, or death) and lung function impairment, and that the regular daily use of low-dose ICS reduced these adverse outcomes regardless of how infrequent asthma symptoms were reported to be at baseline. 5 Two additional new strategies for adolescents and adults, symptom-driven ICS use and single maintenance and reliever therapy (SMART), allow a patient's symptoms to determine the dosage of ICS. These approaches link increased symptoms to a concomitant increase of underlying airway inflammation that can be countered by ICS. SMART involves the use of an inhaler that combines a long-acting β 2 -agonist (LABA) with rapid onset of action (formoterol) with corticosteroid for both daily maintenance and additional as-needed use, whereas symptom-driven ICS use may be implemented with either an ICS inhaler or a combination ICS-LABA inhaler. Both of these strategies link the use of ICS, which improves asthma control and prevents exacerbations, to as-needed β 2agonist treatment, which provides rapid symptom relief.Tripple et al 3 discuss results of the SYGMA 1 and 2 trials, 6,7 which demonstrated that symptom-driven (ie, as-needed) combination budesonide-formoterol improved asthma control and reduced exacerbation risk in individuals with mild persistent asthma compared with symptom-driven short-acting β 2agonists (SABAs) alone. Additionally, although regularly scheduled twice-daily low-dose budesonide provided better symptom control than symptom-driven use of the same medication, the approach of using ...