- 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.
- 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.
- 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).
- Retrospective, observational design.