Asthma: SABA overuse ups risk for exacerbation, mortality

  • Nwaru BI & al.
  • Eur Respir J
  • 16 ene. 2020

  • de Miriam Davis, PhD
  • Clinical Essentials
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Takeaway

  • Overuse of short-acting β2-adrenergic agonists (SABA) is common and increases risk for both asthma exacerbation and overall mortality, according to a Swedish nationwide cohort study.

Why this matters

  • Up to 30 million children and adults younger than 45 years have asthma.
  • Little improvement has been made in asthma control in the last 2 decades.
  • Findings suggest that more aggressive clinical monitoring is warranted.

Study design

  • A retrospective cohort of Swedish national registries (365,324 patients with asthma, aged 12-45 years).
  • SABA overuse was defined as the collection of >2 SABA canisters in the first year after inclusion.
  • Exacerbation was defined as pharmacy collection of a course of oral corticosteroids or emergency department visits and/or hospitalizations because of asthma.
  • Funding: AstraZeneca.

Key results

  • Average follow-up, 85.4 months.
  • 30% of patients overused SABA: 21% collecting 3-5 canisters/year, 7.4% 6-10 canisters/year, and 2% 11+ canisters/year.
  • Higher SABA overuse (canisters/year) was associated with higher risk (HRs; 95% CIs) for asthma exacerbation:
    • 3-5: 1.26 (1.24-1.28).
    • 6-10: 1.44 (1.41-1.46).
    • 11+: 1.77 (1.72-1.83).
  • Higher SABA overuse was associated with higher risk (HRs; 95% CIs) for mortality:
    • 3-5: 1.26 (1.14-1.38).
    • 6-10: 1.66 (1.48-1.87).
    • 11+: 2.33 (2.01-2.71).

Limitations

  • Retrospective, observational design.