Short-acting β(2)-agonist exposure and severe asthma exacerbations: SABINA findings from Europe and North America
| dc.rights.license | open | en_US |
| dc.contributor.author | QUINT, Jennifer K. | |
| dc.contributor.author | ARNETORP, Sofie | |
| dc.contributor.author | KOCKS, Janwillem W. H. | |
| dc.contributor.author | KUPCZYK, Maciej | |
| dc.contributor.author | NUEVO, Javier | |
| dc.contributor.author | PLAZA, Vicente | |
| dc.contributor.author | CABRERA, Claudia | |
| hal.structure.identifier | Bordeaux population health [BPH] | |
| dc.contributor.author | RAHERISON-SEMJEN, Chantal | |
| dc.contributor.author | WALKER, Brandie | |
| dc.contributor.author | PENZ, Erika | |
| dc.contributor.author | GILBERT, Ileen | |
| dc.contributor.author | LUGOGO, Njira Lucia | |
| dc.contributor.author | VAN DER VALK, Ralf J. P. | |
| dc.date.accessioned | 2022-04-19T10:29:30Z | |
| dc.date.available | 2022-04-19T10:29:30Z | |
| dc.date.issued | 2022-03-29 | |
| dc.identifier.issn | 2213-2201 (Electronic) | en_US |
| dc.identifier.uri | https://oskar-bordeaux.fr/handle/20.500.12278/136658 | |
| dc.description.abstractEn | BACKGROUND: Expert national/global asthma management recommendations raise the issue whether a safe threshold of short-acting β(2)-agonist (SABA) use without concomitant inhaled corticosteroids (ICS) exists. OBJECTIVE: To examine SABA and maintenance therapy associations with severe asthma exacerbations across North America and Europe. METHODS: Observational analyses of 10 SABa use IN Asthma (SABINA) datasets involving 1,033,564 patients (≥12 years) from Canada, France, the Netherlands, Poland, Spain, United Kingdom (UK), and United States (US). Negative binomial models (incidence rate-ratio [95% confidence interval]) adjusted for prespecified-covariates]) evaluated associations between SABA and exacerbations. RESULTS: Across severities, 40.2% of patients were prescribed/possessed ≥3 SABA canisters/year. Per GINA-2018 definitions, step 3‒5-treated patients prescribed/possessing ≥3 vs. 1‒2 SABA experienced more severe exacerbations (between 1.08 [1.04‒1.13], US-Medicare; 2.11 [1.96‒2.27], Poland). This association was not observed in all step 1‒2-treated patients (the Netherlands 1.25 [0.91‒1.71]; US-commercial 0.92 [0.91‒0.93]; US-Medicare 0.74 [0.71‒0.76]). We hypothesize that this inverse association between SABA and severe exacerbations in the US datasets was attributable to the large patient population possessing <3 SABA and no maintenance therapy and receiving oral corticosteroid bursts without face-to-face healthcare provider encounters. In US SABA monotherapy-treated patients, ≥3 SABA was associated with more emergency/outpatient visits and hospitalizations (1.31 [1.29‒1.34]). Most GINA 2‒5-treated study patients (60.6%) did not have maintenance therapy for up to 50% of the time; however, the association of ≥3 SABA and severe exacerbations persisted (1.32 [1.18‒1.49]) after excluding these patients and the independent effect was further confirmed when UK SABA data was analyzed as a continuous variable in patients with up to 100% annual coverage for ICS-containing medications. CONCLUSIONS: Increasing SABA exposure is associated with severe exacerbation risk, independent of maintenance therapy. As addressed by GINA, based on studies across asthma severities where as-needed fast-acting bronchodilators with concomitant ICS decrease severe exacerbations compared with SABA, our findings highlight the importance of avoiding a rescue/reliever paradigm utilizing SABA monotherapy. | |
| dc.language.iso | EN | en_US |
| dc.rights | Attribution 3.0 United States | * |
| dc.rights.uri | http://creativecommons.org/licenses/by/3.0/us/ | * |
| dc.title.en | Short-acting β(2)-agonist exposure and severe asthma exacerbations: SABINA findings from Europe and North America | |
| dc.type | Article de revue | en_US |
| dc.identifier.doi | 10.1016/j.jaip.2022.02.047 | en_US |
| dc.subject.hal | Sciences du Vivant [q-bio]/Santé publique et épidémiologie | en_US |
| dc.identifier.pubmed | 35364341 | en_US |
| bordeaux.journal | The Journal of Allergy and Clinical Immunology: In Practice | en_US |
| bordeaux.hal.laboratories | Bordeaux Population Health Research Center (BPH) - UMR 1219 | en_US |
| bordeaux.institution | Université de Bordeaux | en_US |
| bordeaux.institution | INSERM | en_US |
| bordeaux.team | EPICENE_BPH | en_US |
| bordeaux.peerReviewed | oui | en_US |
| bordeaux.inpress | non | en_US |
| hal.identifier | hal-03644596 | |
| hal.version | 1 | |
| hal.date.transferred | 2022-04-19T10:29:33Z | |
| hal.export | true | |
| dc.rights.cc | Pas de Licence CC | en_US |
| bordeaux.COinS | ctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=The%20Journal%20of%20Allergy%20and%20Clinical%20Immunology:%20In%20Practice&rft.date=2022-03-29&rft.eissn=2213-2201%20(Electronic)&rft.issn=2213-2201%20(Electronic)&rft.au=QUINT,%20Jennifer%20K.&ARNETORP,%20Sofie&KOCKS,%20Janwillem%20W.%20H.&KUPCZYK,%20Maciej&NUEVO,%20Javier&rft.genre=article |
