Allergy

SABA overuse in asthma tied to higher mortality and exacerbation risk

June 24, 2025

Study details: This systematic review and meta-analysis included 27 studies (2 randomized trials, 1 prospective cohort, 12 retrospective cohorts, 12 cross-sectional) published from 1981 to November 2023, evaluating adverse outcomes in asthma patients using ≥3 short-acting beta-agonist (SABA) canisters per year. The analysis pooled risk ratios for all-cause mortality and acute exacerbations using random-effects models.

Results: SABA overuse (≥3 canisters/year) was associated with a significantly higher risk of all-cause mortality (risk ratio [RR], 2.04; 95% confidence interval [CI], 1.37–3.04; p < 0.001) and acute exacerbations (RR, 1.93; 95% CI, 1.24–3.03; p < 0.001) compared with lower SABA use. Subgroup analyses confirmed increased exacerbation risk in both retrospective cohort (RR, 1.88) and cross-sectional studies (RR, 2.23).

Clinical impact: The findings reinforce the shift in asthma management away from SABA monotherapy, supporting recommendations to limit SABA use and prioritize anti-inflammatory therapy. Overuse of SABA should prompt clinicians to reassess asthma control and optimize maintenance therapy, in line with current international guidelines discouraging SABA monotherapy due to increased risk of adverse outcomes.

Source:

Tsao CL, et al. (2025, June 10). Allergy. Adverse Outcomes Associated With Short-Acting Beta-Agonist Overuse in Asthma: A Systematic Review and Meta-Analysis. https://pubmed.ncbi.nlm.nih.gov/40491263/