SABA Overuse in Russia – Burden and Possible Causes: An Analysis of the Russian Population in the SABINA III (SABA use IN Asthma) Study

Abstract

Sergey Avdeev,1 Nikolay Voznesenskiy,2 Marina Boldina,3 Galina Ignatova,4 Natalya Kostina,5 Amirzhan Kulbaisov,6 Igor Leshchenko,7 Maarten JHI Beekman8 1Department of Pulmonology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia; 2National Medical Research Center for Pulmonology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia; 3Department of Therapy and Cardiology, Privolzhsky Research Medical University, Nizhny Novgorod, Russia; 4Department of Therapy and Postgraduate Education, South Ural State Medical University, Chelyabinsk, Russia; 5Pulmonology Department, Voronezh Regional Clinical Hospital No 1, Voronezh, Russia; 6Pulmonology Department, Orenburg Regional Hospital No 2, Orenburg, Russia; 7Department of Phthisiatry and Pulmonology, Ural State Medical University, Ekaterinburg, Russia; 8LLC AstraZeneca, The Hague, The NetherlandsCorrespondence: Sergey Avdeev, Email [email protected]: Short-acting β 2-agonists (SABA) overuse is associated with asthma morbidity and mortality. The SABA use IN Asthma (SABINA) program aimed to describe the global use of SABA in patients with asthma. SABINA III study was a cross-sectional study covering 24 countries.Methods: We performed statistical analysis of the Russian population (618 patients recruited in 12 centers) from the SABINA III study. In this study in patients aged ≥ 12 years, data on disease characteristics and asthma treatments were collected using real-time electronic case report forms. Patients were classified by asthma severity and control according to the 2017 GINA. All variables (asthma severity and control, number of severe exacerbations, SABA and other medications use) were analyzed descriptively only, no hypothesis was tested.Results: Majority of the study population consisted of patients with moderate/severe asthma (78.5%), while mild asthma was seen in 21.5%. Asthma was uncontrolled in 36.1% of patients and partly controlled in 33.5%. More than 80% of patients were treated with ICS/LABA fixed-dose combination. Almost half of all patients (47.0%) had at least 1 severe exacerbation in the previous 12 months. SABA over-prescription (≥ 3 canisters per year) was seen in 37% of patients. The frequency of SABA over-prescription was similar in patients with mild (35%) and moderate/severe (38%) asthma. SABA was purchased over-the-counter (OTC) in the past 12 months by 30.1% of all patients, and 14% purchased ≥ 3 canisters of SABA per year. About 91% of patients who purchased SABA OTC already received prescriptions for SABA, of whom 59% were prescribed ≥ 3 canisters per year.Conclusion: Russia is seeing very high level of SABA over-prescription. This is potentially associated with poor asthma control and frequent severe exacerbations. Over-prescription may serve as the main cause for SABA overuse in Russia. To reduce SABA overuse and improve overall asthma control in Russia, it is necessary to educate not just the patients but also the doctors, while actively implementing up-to-date asthma treatments.Keywords: bronchial asthma, asthma control, short-acting β 2-agonists, SABA overuse, over-the-counter use

Keywords

• bronchial asthma
• asthma control
• short-acting β2-agonists
• saba overuse
• over-the-counter use