To gain a global perspective on short-acting β₂-agonist (SABA) prescriptions and associated asthma-related clinical outcomes in patients with asthma, we assessed primary health data across 24 countries in five continents.

SABINA III was a cross-sectional study that employed electronic case report forms at a study visit (in primary or specialist care) to record prescribed medication(s), over-the-counter (OTC) SABA purchases and clinical outcomes in asthma patients (≥12 years old) during the past 12 months. In patients with ≥1 SABA prescriptions, associations of SABA with asthma symptom control and severe exacerbations were analysed using multivariable regression models.

Of 8351 patients recruited (n=6872, specialists; n=1440, primary care), 76.5% had moderate-to-severe asthma and 45.4% experienced ≥1 severe exacerbations in the past 12 months. 38% of patients were prescribed ≥3 SABA canisters; 18.0% purchased OTC SABA, of whom 76.8% also received SABA prescriptions. Prescriptions of 3–5, 6–9, 10–12 and ≥13 SABA canisters (versus 1–2) were associated with increasingly lower odds of controlled or partly controlled asthma (adjusted OR 0.64 (95% CI 0.53–0.78), 0.49 (95% CI 0.39–0.61), 0.42 (95% CI 0.34–0.51) and 0.33 (95% CI 0.25–0.45), respectively; n=4597) and higher severe exacerbation rates (adjusted incidence rate ratio 1.40 (95% CI 1.24–1.58), 1.52 (95% CI 1.33–1.74), 1.78 (95% CI 1.57–2.02) and 1.92 (95% CI 1.61–2.29), respectively; n=4612).

This study indicates an association between high SABA prescriptions and poor clinical outcomes across a broad range of countries, healthcare settings and asthma severities, providing support for initiatives to improve asthma morbidity by reducing SABA overreliance.

为了从全球视角了解哮喘患者的短效 β ₂受体激动剂 (SABA) 处方和相关的哮喘相关临床结果，我们评估了五大洲 24 个国家的初级卫生数据。

SABINA III 是一项横断面研究，它在研究访问（初级或专科护理）中使用电子病例报告表来记录哮喘患者的处方药、非处方药 (OTC) SABA 购买和临床结果。 ≥12 岁）在过去 12 个月内。在有 ≥1 个 SABA 处方的患者中，使用多变量回归模型分析了 SABA 与哮喘症状控制和严重恶化的关联。

在招募的 8351 名患者中（n=6872，专科医生；n=1440，初级保健），76.5% 患有中度至重度哮喘，45.4% 在过去 12 个月内出现≥1 次严重哮喘发作。38% 的患者开了 ≥3 个 SABA 罐；18.0% 购买了 OTC SABA，其中 76.8% 还接受了 SABA 处方。3-5、6-9、10-12 和 ≥13 个 SABA 罐（对比1-2）的处方与哮喘控制或部分控制的几率越来越低相关（调整后的 OR 0.64（95% CI 0.53-0.78），0.49 (95% CI 0.39–0.61)、0.42 (95% CI 0.34–0.51) 和 0.33 (95% CI 0.25–0.45)；n=4597) 和更高的严重恶化率（调整后的发病率比 1.40 (95% CI 1.24–1.58)、1.52 (95% CI 1.33–1.74)、1.78 (95% CI 1.57–2.02) 和 1.92 (95% CI 1.61–2.29)；n=4612)。

这项研究表明，在广泛的国家、医疗机构和哮喘严重程度中，高 SABA 处方与不良临床结果之间存在关联，为通过减少 SABA 过度依赖来改善哮喘发病率的举措提供支持。