Effective Asthma Management: Is It Time to Let the AIR out of SABA?

Abstract

For years, standard asthma treatment has included short acting beta agonists (SABA), including as monotherapy in patients with mild asthma symptoms. In the Global Initiative for Asthma 2019 strategy for the management of asthma, the authors recommended a significant departure from the traditional treatments. Short acting beta agonists (SABAs) are no longer recommended as the preferred reliever for patients when they are symptomatic and should not be used at all as monotherapy because of significant safety concerns and poor outcomes. Instead, the more appropriate course is the use of a combined inhaled corticosteroid–fast acting beta agonist as a reliever. This paper discusses the issues associated with the use of SABA, the reasons that patients over-use SABA, difficulties that can be expected in overcoming SABA over-reliance in patients, and our evolving understanding of the use of “anti-inflammatory relievers” in our patients with asthma.

Evaluation of Proper Inhaler Use in Children Acute Asthma Admitted to the Emergency Department: A Single Center Cross-sectional Study

“…The most important goal in the treatment of asthma is to control the disease by preventing asthma attacks. In particular, regular inhaler treatment should be effectively used to prevent such attacks (3)(4)(5). However, in the present study, we noted that approximately one out of four patients receiving regular therapy did not fulfill all of the practical application steps required using inhaler properly.…”

“…Categorical and descriptive variables were presented as mean ± standard deviation, median respectively. In our study, the mean number of ED visits due to acute asthma attack was 2.8±2.2 (1-10) and the mean systemic corticosteroid use requirement was 1.0±1.4 (1)(2)(3)(4)(5). A total of 18(6.2 %) patients had one or more ED visits in the last year.…”

“…The incidence and prevalence of asthma have been increasing over the past 20 years that is estimated to affect more than 300 million people worldwide (2). The primary goals in the treatment of asthma are to control the daily symptoms of patients, prevent acute asthma attacks, maintain an adequate respiratory function as well as improve the quality of life of such patients (3). Medical therapy in asthma is consisted of rescue and regular inhaler treatment.…”

“…Medical therapy in asthma is consisted of rescue and regular inhaler treatment. Inhaled therapy is recommended as the first choice because it is the most effective route of delivery of medication to the lung and has the least systemic side effects (3). In an inhaled therapy, patients often use a metered-dose inhaler (MDI) or a dry powder inhaler (for example; discus, inhaler capsule or turbuhaler) (3).…”

Global Quality Statements on Reliever Use in Asthma in Adults and Children Older than 5 Years of Age

“…The high rate of poor adherence to ICS suggests that many patients with asthma rely on SABA monotherapy as their sole treatment [ 45 ]. In some parts of the world, such as Australia, SABAs can be bought from community pharmacists without a prescription [ 46 ], which potentially hampers attempts to use ICS alongside bronchodilators to treat the deterioration in asthma control that typically precedes a serious exacerbation.…”