Takeaway
High short-acting β2-agonist (SABA) inhaler use (≥3 canisters/year) is seen in over one-third of UK patients with asthma.
High SABA use is associated with a significant increase in exacerbations and healthcare utilisation, irrespective of asthma severity.
Why this matters
The Global Initiative for Asthma no longer recommends treatment with as-needed SABA alone for symptom relief in adolescents and adults.
Findings suggest that SABA prescription practices need to be aligned with current treatment recommendations.
Study design
As part of the SABINA (SABA use IN Asthma) programme, this study (SABINA I) included 574,913 patients with asthma (age, ≥12 years) using data from the UK Clinical Practice Research Datalink, 2007-2017.
The association between SABA inhaler use by British Thoracic Society (BTS) treatment steps (grouped as BTS steps 1/2 for mild asthma and steps 3-5 for moderate-to-severe asthma) and exacerbations was evaluated.
Funding: AstraZeneca.
Key results
Overall, 218,365 (38%) patients had high SABA inhaler use; 336,412 patients with asthma had linked hospital data; 222,135 (66%) received BTS steps 1/2 treatment and 114,277 (34%) received steps 3-5 treatment.
High SABA vs low SABA (0-2 canisters/year) inhaler users were at a significantly increased risk of:
exacerbations (BTS steps 1/2: adjusted HR [aHR], 1.20; 95% CI, 1.16-1.24; BTS steps 3-5: aHR, 1.24; 95% CI, 1.20-1.28).
asthma-related primary care consultations (BTS steps 1/2: adjusted incidence rate ratio [aIRR], 1.24; 95% CI, 1.23-1.26; BTS steps 3-5: aIRR, 1.13; 95% CI, 1.11- 1.15).
hospital outpatient consultations (BTS steps 1/2: aIRR, 1.19; 95% CI, 1.12-1.27; BTS steps 3-5: aIRR, 1.19; 95% CI, 1.13-1.26).
Limitations
Retrospective design.
Overestimation of actual SABA inhaler use.
This clinical summary first appeared on Univadis, part of the Medscape Professional Network.
Cite this: High SABA Use Linked to Exacerbation Risk, More Healthcare Utilisation - Medscape - Aug 05, 2020.
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