Short-acting beta-2 agonist prescription patterns and clinical outcomes in Chinese patients with asthma: an observational study in mainland China for the SABINA programme

Abstract

Objectives: The SABINA CHINA study aimed to determine prescription data for asthma medication with a focus on SABA and ICS in a representative population of patients with asthma in China. Methods: SABINA China was a multicentre, observational, cross-sectional study with data collected retrospectively from a convenience sample of 25 tertiary centres across China. Patients (age ⩾ 12 years) with ⩾3 consultations/year were enrolled. Data were collected on clinical characteristics, asthma severity, and symptom control (as per GINA 2017), treatment and history of severe exacerbations over the past year. SABA over-prescription was defined as ⩾3 SABA canisters/year. Descriptive statistics are presented. Results: Between March and August 2020, 498 patients were included in the outcome analysis. Mean (SD) age was 48.7 (15.0) years, 57.9% were female and 91% had moderate-to-severe asthma ( n = 453). Overall, 12.5% ( n = 62) and 26.4% ( n = 131) of patients had uncontrolled and partly controlled asthma, respectively. SABA add-on was prescribed to 20.3% ( n = 101) of patients; one patient with moderate-to-severe asthma was prescribed SABA-alone. SABA over-prescription in the overall population was 4.0% ( n = 20; all with moderate-to-severe asthma) and 19.8% (20/101) among those prescribed SABA add-on. In the mild asthma group, 50% ( n = 22) were prescribed ICS/LABA and 43.2% ( n = 19) were prescribed LTRA. Among those with moderate-to-severe asthma, 97.4% ( n = 441) were prescribed ICS/LABA and 55.0% ( n = 249) were prescribed LTRA. Approximately 30% of patients ( n = 149) experienced ⩾1% and 6.6% ( n = 33) ⩾3 severe exacerbations in the preceding year; mean annual number of severe exacerbation/patient was 0.6 (1.2). Among those prescribed SABA add-on, ICS/LABA and LTRA (non-mutually exclusive groups due to overlapping prescriptions), 54.5%, 29.9%, and 35.3% had ⩾1 severe exacerbations, respectively. Conclusion: Among patients with predominantly moderate-to-severe asthma managed in tertiary care and were prescribed SABA, 1 in 5 received ⩾3 canisters/year. Fewer patients who received ICS/LABA prescriptions experienced annual exacerbations than those prescribed SABA add-on.

Over-the-counter use of short-acting beta-2 agonists: a systematic review

“…Moreover, individuals who purchased their SABA with a prescription were more likely to have used preventer medication in the past seven days It appears a third of OTC SABA purchasers had less than normal healthy lung function. Prescription SABA use was associated with preventer use It is likely that this situation may have been worse in regional -rural areas where HCP shortages are more likely – this study was metropolitan area based [ 41 ] Bao et al China A multicenter, observational, cross-sectional study (SABINA III sub-analysis study) March and August 2020 Study targets: patients ≥ 12 years with a documented asthma diagnosis confirmed by the presence of recurrent symptoms and spirometry with, at least 3 annual consultations with HCP, and no other CRD other than asthma. Number of participants : 498 patients recruited from 25 tertiary centers (specialists) across China Used ⩾ 3 SABA canisters per year 5.2% were OTC SABA purchasers in the 12 months prior to the study visit 50% of participants purchased ⩾ 3 SABA canisters (12 months prior to the study visit) Not stated This study was to assess the treatment patterns and clinical outcomes in patients with predominantly moderate-to-severe asthma, who were managed at tertiary centers at China [ 36 ] Azzi et al Australia A real-world cross-sectional observational study October 2017 and October 2018 Study targets: SABA users who were aged 16 years or older, purchased over-the-counter SABA medication for themselves from community pharmacy, and were able to communicate in English.…”

“…Further, in the Australian context, it was evident that 70.1% to 73.9% of people with asthma participating in the studies who purchased SABA over-the-counter at community pharmacies were SABA over-users, meaning they used SABA more than twice a week in the past 4 weeks [ 15 , 36 ]. Our polled data for all studies reviewed indicate that 14% to 66.4% of asthma patients had purchased three or more SABA canisters over-the-counter over a period of 12 months [ 35 , 37 – 39 , 41 – 43 ].…”

Omalizumab for Chinese patients with moderate-to-severe allergic asthma in real-world clinical setting: a prospective, observational study

“…Furthermore, a recent study in China reported that moderate-to-severe asthma was approximately 16% of newly diagnosed cases 4. Another cross-sectional study in 2020 found that 38.9% of Chinese patients did not achieve satisfactory asthma control 5…”

“…4 Another cross-sectional study in 2020 found that 38.9% of Chinese patients did not achieve satisfactory asthma control. 5 Previous studies have reported that nearly 90% of patients with severe asthma were cases of allergic asthma, 6 7 in which IgE plays a critical role. IgE leads to an inflammatory cascade by activating effector cells (eg, mast cells and basophils) through high-(FcεR I) or…”