&lt;p&gt;Asthma and COVID-19: In Defense of Evidence-Based SABA&lt;/p&gt;

Amirav, Israel; Newhouse, Michael T.

doi:10.2147/jaa.s279061

Cited by 5 publications

(3 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In primary care and emergency care settings (emergency department, during hospitalization, or in intensive care unit), immediate and repeated administrations of inhaled SABA via pressurised metered dose inhaler (pMDI), pMDI plus spacer, or nebulization are recommended as the initial treatment for exacerbations [ 1 , 27 ]. A shortage of SABA inhalers during the COVID-19 pandemic reinforced the importance of the role of inhaled SABA in managing asthma [ 10 ].…”

Section: Current Positioning Of Sabas As Reliever Medicationsmentioning

confidence: 99%

“…The role of as-needed inhaled short-acting β 2 -agonists (SABAs) in the management of asthma has become the subject of a debate as a result of disparities between asthma management guidelines [ 1 – 9 ] and differing opinions among the respiratory professional community [ 10 – 13 ], while there is universal agreement that inhaled corticosteroids (ICS) are the most effective anti-inflammatory treatment for asthma [ 1 – 9 , 12 – 14 ]. The Global Initiative for Asthma (GINA) now recommends as-needed low-dose ICS-formoterol for symptom relief (symptom driven approach) for mild asthma and ICS-formoterol maintenance and reliever therapy (MART) for moderate to severe asthma (track 1) in preference to as-needed SABA plus ICS (step 1) and regular dosing with an ICS-containing maintenance therapy plus SABA as-needed with all severities of asthma over steps 2 to 4 (track 2) [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

SABAs as Reliever Medications in Asthma Management: Evidence-Based Science

Amirav¹,

García²,

Le³

et al. 2023

Adv Ther

Self Cite

View full text Add to dashboard Cite

The role of as-needed inhaled short-acting β 2 -agonists (SABAs) in the management of asthma has become a subject of debate due to differing opinions in the professional community relating to the use of SABAs. In this article, we summarize the current position of SABAs when used as reliever medications and examine the challenges to appropriate use including a critique of the data that have led to the condemnation of SABA used as a reliever. We consider the evidence for the appropriate use of SABA as a reliever together with practical solutions to ensure such use, including identifying patients at risk of misusing their SABA relievers and managing issues of inhaler technique and treatment adherence. We conclude that inhaled corticosteroid (ICS)-based maintenance treatment with SABA used as-needed as a reliever is an effective and safe treatment for patients with asthma, with no scientific evidence of a causal link between SABA use as a reliever and mortality or serious adverse events (including exacerbations). Increased SABA use warns of a deterioration in asthma control, and patients at risk of misusing their ICS and SABA medication should be rapidly identified to ensure they are receiving adequate ICS-based controller therapy. Appropriate use of ICS-based controller therapy and as-needed SABA should be encouraged and promoted with educational activities.

show abstract

Section: Current Positioning Of Sabas As Reliever Medicationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

SABAs as Reliever Medications in Asthma Management: Evidence-Based Science

Amirav¹,

García²,

Le³

et al. 2023

Adv Ther

Self Cite

View full text Add to dashboard Cite

show abstract

“…The advice on managing asthma remains unchanged during the COVID-19 pandemic [12,13,48]. A shortage of asthma inhalers was observed during the pandemic; the shortage of short-acting b 2 -agonist (SABA) inhalers reinforced the importance and well-established role of SABA in the current management of asthma [49]. For most patients with asthma, the risk of inadequately treating an asthma attack is worse than the risk from COVID-19 infection [12].…”

Section: How Can Asthma Attacks Be Managed Effectively In Primary Car...mentioning

confidence: 99%

Primary Care Management of Asthma Exacerbations or Attacks: Impact of the COVID-19 Pandemic

et al. 2022

View full text Add to dashboard Cite

The COVID-19 pandemic has brought a renewed focus on appropriate management of chronic respiratory conditions with a heightened awareness of respiratory symptoms and the requirement for differential diagnosis between an asthma attack and COVID-19 infection. Despite early concerns in the pandemic, most studies suggest that well-managed asthma is not a risk factor for more severe COVID-related outcomes, and that asthma may even have a protective effect. Advice on the treatment of asthma and asthma attacks has remained unchanged. This article describes some challenges faced in primary care asthma management in adults and in teenagers, particularly their relevance during a pandemic, and provides practical advice on asthma attack recognition, classification, treatment and continuity of care. Acute attacks, characterised by increased symptoms and reduced lung function, are often referred to as exacerbations of asthma by doctors and nurses but are usually described by patients as asthma attacks. They carry a significant and underestimated morbidity and mortality burden. Many patients experiencing an asthma attack are assessed in primary care for treatment and continuing management. This may require remote assessment by telephone and home monitoring devices, where available, during a pandemic. Differentiation between an asthma attack and a COVID-19 infection requires a structured clinical assessment, taking account of previous medical and family history. Early separation into mild, moderate, severe or life-threatening attacks is helpful for continuing good management. Most attacks can be managed in primary care but when severe or unresponsive to initial treatment, the patient should be appropriately managed until transfer to an acute care facility can be arranged. Good quality care is important to prevent further attacks and must include a follow-up appointment in

show abstract