Long-Term Use of Short-Acting β2-Agonists in Patients With Adult-Onset Asthma
Vähätalo, Iida; Lehtimäki, Lauri; Tuomisto, Leena E.; Karjalainen, Jussi; Niemelä, Onni; Ilmarinen, Pinja; Kankaanranta, Hannu (2022-04)
Vähätalo, Iida
Lehtimäki, Lauri
Tuomisto, Leena E.
Karjalainen, Jussi
Niemelä, Onni
Ilmarinen, Pinja
Kankaanranta, Hannu
04 / 2022
Julkaisun pysyvä osoite on
https://urn.fi/URN:NBN:fi:tuni-202208166453
https://urn.fi/URN:NBN:fi:tuni-202208166453
Kuvaus
Peer reviewed
Tiivistelmä
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, and previous studies on the topic have not included information about adherence to inhaled corticosteroids (ICS) nor disease control, both affecting the need of SABA. Objective: To evaluate the clinical characteristics of SABA and ICS usage in newly diagnosed adult-onset asthma patients during a 12-year follow-up period. Methods: In the Seinäjoki Adult Asthma Study, 203 patients with adult-onset asthma were followed for 12 years. Information on dispensed SABA and ICS during the follow-up was obtained from the Finnish Social Insurance Institution. High SABA use was defined as ≥36 canisters in 12 years, corresponding to an average of ≥3 dispensed canisters/y. Results: Patients were dispensed median 6 (interquartile range: 3-16) SABA canisters and 48 (18-67) ICS canisters over 12 years, corresponding to 2 (1-4) and 11 (5-16) puffs/week, respectively. Only 10% of the patients were classified as high SABA users during this period. Obesity (body mass index ≥30) and high Airways Questionnaire 20 symptom scores at baseline predicted high long-term SABA use (incidence rate ratio: 1.53 [1.01-2.30] and 1.04 [1.00-1.08], respectively). High SABA users had higher ICS adherence, higher blood neutrophil counts, more comorbidities, and used more oral corticosteroid and antibiotic courses versus low SABA users. Conclusion: High SABA use was infrequent in patients with confirmed adult-onset asthma. However, as high SABA use is associated with more severe asthma, these patients should be recognized in clinical practice.
Kokoelmat
- TUNICRIS-julkaisut [16951]