@article{4b8e3d3562ff4fd7aa94c4117619caa7,
title = "Long-Term Use of Short-Acting β2-Agonists in Patients With Adult-Onset Asthma",
abstract = "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 Sein{\"a}joki 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.",
keywords = "Adult-onset, Asthma, Asthma control, Asthma treatment, Follow-up, Long-term, Obesity, Prognosis, Reliever therapy, Short-acting β-agonists",
author = "Iida V{\"a}h{\"a}talo and Lauri Lehtim{\"a}ki and Tuomisto, {Leena E.} and Jussi Karjalainen and Onni Niemel{\"a} and Pinja Ilmarinen and Hannu Kankaanranta",
note = "Funding Information: This work was supported by the Tampere Tuberculosis Foundation (Tampere, Finland), the Pirkanmaa Regional Fund of the Finnish Cultural Foundation (Helsinki, Finland), the Finnish Anti-Tuberculosis Association Foundation (Helsinki, Finland), the Research Foundation of the Pulmonary Diseases (Helsinki, Finland), the Ida Montini Foundation (Kerava, Finland), Allergy Research Foundation (Helsinki, Finland), Competitive State Research Financing of the Expert Responsibility Area of Tampere University Hospital (Tampere, Finland), and the Medical Research Fund of Sein{\"a}joki Central Hospital (Sein{\"a}joki, Finland). None of the sponsors had any involvement in the planning, execution, drafting, or write-up of this study. Funding Information: This work was supported by the Tampere Tuberculosis Foundation (Tampere, Finland), the Pirkanmaa Regional Fund of the Finnish Cultural Foundation (Helsinki, Finland), the Finnish Anti-Tuberculosis Association Foundation (Helsinki, Finland), the Research Foundation of the Pulmonary Diseases (Helsinki, Finland), the Ida Montini Foundation (Kerava, Finland), Allergy Research Foundation (Helsinki, Finland), Competitive State Research Financing of the Expert Responsibility Area of Tampere University Hospital (Tampere, Finland), and the Medical Research Fund of Sein{\"a}joki Central Hospital (Sein{\"a}joki, Finland). None of the sponsors had any involvement in the planning, execution, drafting, or write-up of this study.Conflicts of interest: I. V{\"a}h{\"a}talo reports personal fees from Astra Zeneca, outside the submitted work. L. Lehtim{\"a}ki reports grants and personal fees from Orion Pharma; personal fees from Astra Zeneca, Boehringer Ingelheim, Chiesi, Circassia, GSK, Mundipharma, Novartis, and Sanofi; and shares of Ausculthing Oy, outside the submitted work. L. E. Tuomisto reports personal fees from Boehringer Ingelheim, Astra Zeneca, and GlaxoSmithKline; and nonfinancial support from Chiesi, outside the submitted work. J. Karjalainen reports personal fees from Astra Zeneca, Boehringer Ingelheim, Chiesi, Sanofi, GlaxoSmithKline, Novartis, and Orion Pharma, outside the submitted work. P. Ilmarinen is an employee of GlaxoSmithKline; and reports personal fees from GlaxoSmithKline, Novartis, Mundipharma, and Astra Zeneca, outside the submitted work. H. Kankaanranta reports personal fees from Astra Zeneca, Orion Pharma, Mundipharma, Boehringer Ingelheim, Chiesi Pharma AB, GlaxoSmithKline, MSD, Novartis, and Sanofi Genzyme, outside the submitted work. O. Niemel{\"a} declares that he has no relevant conflicts of interest. Publisher Copyright: {\textcopyright} 2022 The Authors",
year = "2022",
month = apr,
doi = "10.1016/j.jaip.2022.03.027",
language = "English",
volume = "10",
pages = "2074--2083.e7",
journal = "Journal of Allergy and Clinical Immunology: In Practice",
issn = "2213-2198",
publisher = "Elsevier",
number = "8",
}
