ArticleThe European respiratory journal2020
Overuse of short-acting β
Article in The European respiratory journal, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 258 papers, 7 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
258 citing papers in PubMed, 7 syntheses or guidelines pooled it, 434 citations in OpenAlex.
- Risk Factors for Life-Threatening Asthma Attacks and Asthma-Related Mortality in Children-A Systematic Review.Pediatric pulmonology · 2025Pooled it
- Adverse Outcomes Associated With Short-Acting Beta-Agonist Overuse in Asthma: A Systematic Review and Meta-Analysis.Allergy · 2025Pooled it
- Regular versus as-needed treatments for mild asthma in children, adolescents, and adults: a systematic review and network meta-analysis.BMC medicine · 2025Pooled it
- Safety outcomes of salbutamol: A systematic review and meta-analysis.The clinical respiratory journal · 2023Pooled it
- Perceptions, attitudes, and behaviors of asthma patients towards the use of short-acting β2-agonists: A systematic review.PloS one · 2023Pooled it
- The availability, cost, and affordability of essential medicines for asthma and COPD in low-income and middle-income countries: a systematic review.The Lancet. Global health · 2022Pooled it
- Increased versus stable doses of inhaled corticosteroids for exacerbations of chronic asthma in adults and children.The Cochrane database of systematic reviews · 2022Pooled it
- Trial
- Reducing short-acting beta-agonist overprescribing in general practice: Evaluation of a quality improvement programme in East London.The European journal of general practice · 2026Article
- Pharmacological assessment of drugs retained in the 1Naunyn-Schmiedeberg's archives of pharmacology · 2026Article
- From mild-to-moderate to severe asthma: risk factors and patient profiles from the NORDSTAR cohort.American journal of respiratory and critical care medicine · 2026Observational
- Improving paediatric asthma outcomes in rural settings: clinical effectiveness of a multicomponent asthma care model.ERJ open research · 2026Article
- Airway inflammation and asthma control in patients using salbutamol or budesonide/formoterol reliever: a randomised, controlled study.ERJ open research · 2026Article
- Prolonged elevated heart rate and 28-day in-hospital mortality in patients with asthma-related critical illness: a multicenter retrospective cohort study.Journal of thoracic disease · 2026Article
- Clinical Outcomes Following Transition from ICS/LABA to Single-Inhaler Triple Therapy in Patients with Uncontrolled Asthma: A Real-World Cohort Study.Medicina (Kaunas, Lithuania) · 2026Observational
- Environmental prescribing for asthma and chronic obstructive pulmonary disease.African journal of primary health care & family medicine · 2026Article
- Mechanisms and therapeutic strategies of asthma: from bench to bedside.Signal transduction and targeted therapy · 2026Review
- Pediatric Mild Asthma: Bridging Current Gaps to Improve Future Care.Pediatric pulmonology · 2026Review
- Article
- Decarbonising Respiratory Care: The Impact of a Low-Carbon Salbutamol Pressurised Metered-Dose Inhalers.Allergy · 2026Article
198 more citing papers are in PubMed but not listed here.
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Authors and funding
6 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOveruse of short-acting β
methodsBy linking data from Swedish national registries, asthma patients aged 12-45 years with two or more collections of drugs for obstructive lung disease during 2006-2014 were included. SABA overuse was defined as collection of more than two SABA canisters in a 1-year baseline period following inclusion. SABA use was grouped into 3-5, 6-10 and ≥11 canisters per baseline-year. Cox regression was used to examine associations between SABA use and exacerbation (hospitalisations and/or oral corticosteroid claims) and mortality.
resultsThe analysis included 365 324 asthma patients (mean age 27.6 years; 55% female); average follow-up was 85.4 months. 30% overused SABA, with 21% collecting 3-5 canisters per year, 7% collecting 6-10 canisters per year and 2% collecting ≥11 canisters per year. Increasing number of collected SABA canisters was associated with increased risk of exacerbation, as follows. 3-5 canisters: hazard ratio (HR) 1.26 (95% CI 1.24-1.28); 6-10 canisters: 1.44 (1.41-1.46); and ≥11 canisters: 1.77 (1.72-1.83), compared to two or fewer canisters per year. Higher SABA use was associated with incrementally increased mortality risk (2564 deaths observed), as follows. 3-5 canisters: HR 1.26 (95% CI 1.14-1.39); 6-10 canisters 1.67 (1.49-1.87); and ≥11 canisters: 2.35 (2.02-2.72) compared to two or fewer canisters per year.
conclusionOne-third of asthma patients in Sweden collected three or more SABA canisters annually. SABA overuse was associated with increased risks of exacerbation and mortality. These findings emphasise that monitoring of SABA usage should be key in improving asthma management.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.