SynthesisAllergy2025
Adverse Outcomes Associated With Short-Acting Beta-Agonist Overuse in Asthma: A Systematic Review and Meta-Analysis.
Synthesis in Allergy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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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
12 citing papers in PubMed.
- Probiotics in asthma: immunoregulatory mechanisms and emerging opportunities for respiratory delivery-a narrative review.Translational pediatrics · 2026Review
- Utilization Patterns of Nebulized Glycopyrronium in Patients Hospitalized for Acute Exacerbations of Obstructive Airway Disease (AEOAD)-Indian Expert Perspectives.Advances in respiratory medicine · 2026Article
- Effectiveness and Safety of Budesonide/Formoterol in Asthma: A Systematic Review.Healthcare (Basel, Switzerland) · 2026Review
- Incorporating New Guidelines into School-Based Asthma Management.Current allergy and asthma reports · 2026Review
- Article
- Comparison of tear function in patients with and without mental disorders: A systematic review and meta-analysis.Biomedical journal · 2026Article
- Exacerbations and Management of Asthma in Viral Lower Respiratory Tract Infections: The Significance of Immunoglobulin E.Immunity, inflammation and disease · 2026Review
- Optimizing the Use of Inhaled Corticosteroid/Long-Acting βAdvances in therapy · 2026Review
- Article
- Advancements in diagnosis, preventive care, and future directions in the holistic management of pediatric asthma.Frontiers in pediatrics · 2026Review
- A current assessment of family physicians' knowledge and attitudes toward asthma management in primary care in Turkey according to the GINA strategy report.NPJ primary care respiratory medicine · 2025Article
- Reconsidering the overuse of short-acting βERJ open research · 2025Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe 2019 Global Initiative for Asthma (GINA) report no longer recommended short-acting beta-agonists (SABA) monotherapy due to associated complications and a lack of anti-inflammatory properties. This systematic review and meta-analysis aimed to evaluate adverse outcomes associated with SABA overuse in patients with asthma.
methodsPubMed, Cochrane Library, EMBASE, and Web of Science databases were searched for studies on SABA overuse (≥ 3 SABA canisters/year) in patients with asthma, from 1981 to November 2023. Randomized controlled trials (RCTs), cohort studies, and cross-sectional studies were included. Pooled risk ratios (RRs) were calculated for dichotomous measures of all-cause mortality and acute exacerbations using random-effects models and Mantel-Haenszel weighting. Subgroup analyses were conducted based on study design.
resultsOut of 626 records, 27 studies (2 RCTs, 1 prospective cohort study, 12 retrospective cohort studies, and 12 cross-sectional studies) were included. SABA overuse (≥ 3 SABA canisters/year) was associated with significantly higher mortality (2743 of 130,629 in the overuse group versus 3534 of 300,451 in controls; RR = 2.04, 95% confidence interval, CI = 1.37-3.04; p < 0.001) and a significantly higher rate of acute exacerbations (60,320 of 165,271 in the overuse group versus 84,439 of 376,845 in controls; RR = 1.93, 95% CI = 1.24-3.03; p < 0.001). An increased risk of acute exacerbations was observed in retrospective cohort studies (RR = 1.88, 95% CI = 1.43-2.47; p < 0.001) and cross-sectional studies (RR = 2.23, 95% CI = 1.04-4.77; p < 0.001).
conclusionsSABA overuse was associated with increased rates of mortality and acute exacerbations in patients with asthma, supporting guidelines that advise against SABA monotherapy in asthma management.
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