Use of short-acting ß2-agonists in patients with adult-onset asthma during 12-years

Abstract

Background: Short-term studies have associated high use of short-acting β₂-agonists (SABA) with increased risk of exacerbations, emergency visits and asthma-related costs. However, no studies exist on long-term SABA use, adherence to inhaled corticosteroids (ICS) and disease control.

Aims and objectives: To evaluate the relation of SABA and ICS usages during 12 years and whether high SABA use exists in patients with new-onset adult asthma.

Methods: In Seinäjoki Adult Asthma Study (SAAS) a total of 203 patients with adult-onset asthma were followed for 12 years. Information on dispensed SABA and ICS during the 12 years were obtained from the Finnish Social Insurance Institution. High SABA use was defined as ≥36 canisters in 12 years corresponding to on average ≥3 dispensed canisters per year.

Results: Patients with adult-onset asthma dispensed median 6 canisters (interquartile range 3-16) of SABA and 48 (18-67) canisters of ICS during 12 years, corresponding to 1 (1-4) and 11 (5-16) puffs/week, respectively. Only 21 (10%) of the patients used high amounts of SABA during the 12-year follow-up period. Obesity (BMI ≥30) and higher AQ20 symptom scores at baseline predicted higher SABA use during the follow-up (IRR 1.53 (1.01-2.3) and 1.04 (1.0-1.08), respectively). High SABA users had higher 12-year adherence to ICS, higher number of blood neutrophils and comorbidities and used more oral corticosteroid and antibiotic courses vs. those using less SABA.

Conclusions: High use of SABA was rare in patients with confirmed adult-onset asthma. However, as high SABA use indicated more severe asthma, the patients should be recognized in clinical practice. Weight loss should be prioritized shortly after asthma diagnosis.