As SABA overuse is associated with exacerbations and mortality, GINA no longer recommends SABA only as a preferred reliever in asthma. A consistent pattern of high SABA use from the SABINA programme would indicate a global public health issue. http://bit.ly/33XDrlbCite this article as: Cabrera CS, Nan C, Lindarck N, et al. SABINA: global programme to evaluate prescriptions and clinical outcomes related to short-acting β 2 -agonist use in asthma.

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SUMMARYA guided, adjustable‐dosing regimen with budesonide/formoterol was investigated in asthma patients. In a randomised, open, multicentre study, 1034 patients received budesonide/formoterol (Symbicort®, Turbuhaler®,) 80/4.5 μg or 160/4.5 μg (depending on pre‐study inhaled corticosteroid dose) two inhalations twice daily for four weeks, followed by adjustable or fixed maintenance dosing for six months. Patients receiving adjustable dosing stepped down to one inhalation twice daily if symptoms were controlled and could, if symptoms worsened, step up to four inhalations twice daily for one or two weeks according to a self‐guided management plan. The primary efficacy variable was occurrence of exacerbations. Compared with fixed dosing, adjustable dosing was associated with fewer patients experiencing exacerbations (6.2% vs 9.5%, NNT 30, p<0.05), fewer daily inhalations of budesonide/formoterol (2.35 vs 3.95, p<0.001), lower costs (six‐month saving €98, p<0.001) and was similarly well tolerated. Adjustable maintenance dosing with budesonide/formoterol provides more effective asthma control than fixed dosing, and reduces costs.