The SABINA III study, which comprised 8351 participants from 24 countries, demonstrated that high SABA prescriptions led to poorer asthma control and higher rates of severe asthma exacerbations.
Asthma is a prevalent health condition across the globe and the most common chronic condition during childhood. The emergence of inhaled corticosteroids has led to a significant decline in asthma deaths and asthma-related hospitalizations. This trend is also seen in countries with poor asthma care resources. However, additional measures are required to avoid preventable deaths and morbidity. Excessive administration of short-acting beta-2-agonists (SABAs) and underuse of inhaled corticosteroids have led to the emergence of potentially modifiable issues. SABAs can be replaced by a combination of rapid-onset long-acting beta-2-agonists (LABAs) and low-dose inhaled corticosteroids, administered in the form of a single inhaler. This approach can potentially reduce the overuse of SABAs and facilitate the administration of anti-inflammatory treatment. SABINA (SABA use in asthma) III investigated the effects of over-the-counter and prescription SABAs and other medications for asthma on clinical outcomes in asthma patients from 24 countries.
This multi-country cross-sectional study, published in The European Respiratory Journal, acquired data from 24 countries. Patients suffering from acute respiratory conditions or chronic respiratory diseases other than asthma were excluded from the study. The Global Initiative for Asthma (GINA) assessment was used for the evaluation of asthma symptom control. The acquired data were subjected to statistical analyses.
A total of 8351 patients were recruited from Africa, the Middle East, Latin America, Russia, Australia, and Asia in the primary analysis of this study. The majority of the participants were enrolled in the study by specialists. Of the patients with mild asthma, 53.6% were prescribed three or more SABA canisters as monotherapy. Higher SABA prescriptions were related to an increased risk of severe asthma exacerbations. This risk increased with an increase in the prescription of SABA canisters.
The study findings suggest that SABA prescriptions are associated with poor asthma outcomes. Poor asthma outcomes were observed in a broad range of healthcare settings, asthma severities, and a range of countries. This supports the need to address SABA overuse in asthma treatment to achieve a further decline in asthma mortality and morbidity. Similar associations are observed in SABINA I in the United Kingdom and SABINA II in Italy and Sweden.
Reference
Bateman, E. D., Price, D. B., Wang, H. C., Khattab, A., Schonffeldt, P., Catanzariti, A., . . . Beekman, M. (2022). Short-acting β(2)-agonist prescriptions are associated with poor clinical outcomes of asthma: the multi-country, cross-sectional SABINA III study. European Respiratory Journal, 59(5). https://doi.org/10.1183/13993003.01402-2021
