PT  - JOURNAL ARTICLE
AU  - Mark Levy
AU  - Guilherme Safioti
AU  - Michael Reich
AU  - Randall Brown
AU  - Michael Depietro
TI  - SABA use increase weeks before asthma exacerbations recorded via a digital inhaler
AID  - 10.1183/13993003.congress-2021.PA3397
DP  - 2021 Sep 05
TA  - European Respiratory Journal
PG  - PA3397
VI  - 58
IP  - suppl 65
4099  - http://erj.ersjournals.com/content/58/suppl_65/PA3397.short
4100  - http://erj.ersjournals.com/content/58/suppl_65/PA3397.full
SO  - Eur Respir J2021 Sep 05; 58
AB  - Background: Increased use of short-acting beta-agonists (SABA) may signal an impending exacerbation. An electronic multi-dose dry powder inhaler with integrated sensors (ProAir Digihaler; salbutamol 90 µg/dose) records objective inhaler use data and may provide early information about asthma worsening.Aims and objectives: Identify changes in SABA use before asthma exacerbations.Methods: This retrospective, post-hoc analysis assessed data from a 12-week, open-label study of adult patients (pts) with poorly controlled asthma and ≥1 exacerbation in the prior year. Pts used ProAir Digihaler (1–2 inhalations, q4h) as needed; all used inhaled steroid-containing controllers.Results: 360 pts made ≥1 valid inhalation from the Digihaler. In total, 64 pts had 78 exacerbations. For this analysis, pts with exacerbations in the first 30 days were excluded. Aggregate data for 28 pts who had an exacerbation ≥30 days post-enrolment showed increased mean (SD) daily SABA use from days -30 (2.0 [3.2]) to -15 (3.3 [3.7]) prior to an exacerbation, and a further increase from day -14 (2.6 [3.1]) to day of exacerbation (3.8 [3.9]). Mean daily SABA use was greater for pts who had an exacerbation vs those who did not.Conclusions: Data from ProAir Digihaler show increased SABA use up to 30 days before an exacerbation. This early signalling may suggest disease deterioration, and potentially allow for pre-emptive, more effective personalised asthma management. FootnotesCite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA3397.This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).