The risk for moderate exacerbations in patients with asthma treated with short-acting beta-agonists only

Clinical Research Results Abstract Introduction: In 2020, the international guideline for asthma management and prevention of the Global Initiative for Asthma (GINA) changed radically, from prescribing a short-acting beta-agonist (SABA) as needed to a combihaler of inhaled corticosteroids (ICS) and formoterol as needed to reduce exacerbation risk. We aimed to determine the risk for moderate exacerbations in patients using SABA only in general practice, and compare this risk to patients that were using ICS. Methods: This was a retrospective cohort study using a database containing data of 89 Dutch general practices from 1-1-2017 until 31-12-2019. Patients ≥16 years, with a recorded asthma diagnosis for which they used asthma medication in 2017 were included. Patients with comorbidities that can lead to the prescription of oral corticosteroids, like COPD were excluded. The prevalence of patients that used SABA only that had moderate exacerbation(s), defined as an oral corticosteroid prescription, was counted in 2018 and 2019 and compared to the group that used ICS. Logistic regression analysis was used to compare the risk for moderate exacerbations between these groups. Results: 6,591 asthma patients were selected and 15.1% used SABA only. 3.5% of patients in the SABA only group had moderate exacerbations during 2 year follow-up compared to 17.4% in the ICS group (Odds Ratio (OR), 0.22; 95%CI, 0.15-0.31). Four patients in the SABA only group (0.4%) had more than one exacerbation. Discussion: Patients who used SABA only have a low exacerbation risk. Based on our data, the GINA treatment recommendation to prescribe ICS-formoterol to all patients with SABA only in order to prevent exacerbations, seems to benefit a small group of patients with SABA only. Research Idea Abstract Service Development & Evaluation Abstract Declaration of Interest Authors have no conflict of interest. This study was not funded. References and Clinical Trial Registry Information