Korean J Intern Med.  2024 Jan;39(1):123-136. 10.3904/kjim.2023.086.

Short-acting β2-agonist prescriptions in patients with asthma: findings from the South Korean cohort of SABINA III

Affiliations
  • 1Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
  • 2Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
  • 3Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
  • 4Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
  • 5Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
  • 6Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea
  • 7Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
  • 8AstraZeneca, The Hague, The Netherlands

Abstract

Background/Aims
Despite short-acting β2-agonist (SABA) overuse being associated with poor asthma outcomes, data on SABA use in South Korea is scarce. Herein, we describe prescription patterns of SABA and other asthma medications in patients from the South Korean cohort of the SABA use IN Asthma (SABINA) III study.
Methods
This study included patients with asthma aged ≥ 12 years, who had ≥ 3 consultations with the same healthcare provider, and medical records containing data for ≥ 12 months prior to the study visit. Patients were classified by investigator-defined asthma severity (per 2017 Global Initiative for Asthma recommendations) and practice type (primary or specialist care). Data on disease characteristics, asthma treatments, and clinical outcomes in the 12 months before the study visit were collected using electronic case report forms.
Results
Data from 476 patients (mean age, 55.4 years; female, 63.0%) were analyzed. Most patients were treated by specialists (83.7%) and had moderate-to-severe asthma (91.0%). Overall, 7.6% of patients were prescribed ≥ 3 SABA canisters (defined as over-prescription). In patients prescribed SABA in addition to maintenance therapy, 47.4% were over-prescribed SABA. Most patients (95.4%) were prescribed a fixed-dose combination of an inhaled corticosteroid and a long-acting β2-agonist as maintenance therapy. Although asthma was well-controlled/partly-controlled in 91.6% of patients, 29.6% experienced ≥ 1 severe asthma exacerbation.
Conclusions
SABA over-prescription was reported in nearly 50% of patients prescribed SABA in addition to maintenance therapy, underscoring the need to align clinical practices with the latest evidence-based recommendations and educate physicians and patients on appropriate SABA use.

Keyword

Anti-asthmatic agents; Anti-inflammatory agents; Asthma; Bronchodilator agents; Glucocorticoids; South Korea
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