Preview

PULMONOLOGIYA

Advanced search

Overuse of short-acting β2 -agonists in the Russian population with asthma: the persisting threat

https://doi.org/10.18093/0869-0189-2022-32-5-661-669

Abstract

Short-acting β2 -agonists (SABA) overuse is associated with negative outcomes in asthma patients. There is a lack of actual data about patterns of SABA overuse in the Russian population with asthma.

The aim. To investigate patterns of SABA overuse in the Russian population with asthma.

Methods. Data from the Russian population of “SABA use IN Asthma (SABINA) III” study were analyzed. SABINA III was a cross-sectional observational study covering 24 countries. Adults and adolescents with a documented diagnosis of asthma for at least 12 months were enrolled in the study. Data on disease characteristics and asthma treatments during previous 12 months were collected using real-time electronic case report forms and were analyzed with methods of descriptive statistics.

Results. Majority of the Russian population (n = 618) consisted of patients with moderate/ severe asthma (78.5%). Asthma was uncontrolled or partly controlled in 70% of patients. 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% of all patients, while 14% purchased ≥ 3 canisters of SABA per year. More than 90% of patients who purchased SABA OTC, already received prescriptions for SABA, of whom 59% were prescribed ≥ 3 canisters per year.

Conclusion. Russia is faced with very high level of SABA overuse. Over-prescription is the main cause for SABA overuse. To reduce SABA overuse, it is necessary to educate both patients and doctors, and actively implement up-to-date asthma treatments.

 

About the Authors

S. N. Avdeev
Federal State Autonomous Educational Institution of Higher Education I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)
Russian Federation

Sergey N. Avdeev, Doctor of Medicine, Professor, Academician of Russian Academy of Sciences, Head of the Pulmonology Department, N.V.Sklifosovsky Institute of Clinical Medicine, Director National Medical Research Center for Pulmonology, Federal State Autonomous Educational Institution of Higher Education I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Leading Researcher, Federal Pulmonology Research Institute, Federal Medical and Biological Agency of Russia

ul.Trubetskaya 8, build. 2, Moscow, 119991

SPIN-code: 1645-5524



N. A. Voznesenskiy
Federal State Autonomous Educational Institution of Higher Education I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)
Russian Federation

Nikolay A. Voznesenskiy, Candidate of Medicine, Head of the Department of Educational Programs and Scientific Research, National Medical Research Center for Pulmonology

ul.Trubetskaya 8, build. 2, Moscow, 119991



N. V. Boldina
Federal State Budgetary Educational Institution of Higher Education “Privolzhsky Research Medical University” of the Ministry of Health of the Russian Federation
Russian Federation

Marina V. Boldina, Candidate of Medicine, Associate Professor of the Department of Therapy and Cardiology

Minin and Pozharsky pl. 10/1, Nizhny Novgorod, 603005



E. I. Van’kova
Kazan’ City Outpatient Clinic No.17

Elena I. Van’kova, pulmonologist

ul. Gladilova 28/5, Kirovskiy, Kazan’, 420032



I. V. Zaykova-Khelimskaya
Federal State Budgetary Educational Institution of Higher Education “Far-East State Medical University” of the Ministry of Healthcare of the Russian Federation

Irina V. Zaykova-Khelimskaya, Doctor of Medicine, Professor of the Department of Hospital Therapy

ul. Muravyov-Amursky 35, Khabarovsk, 35680000



G. L. Ignatova
South Ural State Medical University, Healthcare Ministry of Russia

Galina L. Ignatova, Doctor of Medicine, Professor, Head of the Department of Therapy, Institute of Postgraduate Physician Training

ul. Vorovskogo 64, Chelyabinsk, 454092



N. E. Kostina
Voronezh Regional Clinical Hospital No.1

Natal’ya E. Kostina, Candidate of Medicine, Head of the Department of Pulmonology

Moskovskiy prospect 151, Voronezh, 394066

 



I. V. Kostrova
Federal State Budgetary Educational Institution of Higher Professional Education “Amur State Medical Academy” of the Ministry of Healthcare of the Russian Federation

Irina V. Kostrova, Candidate of Medicine, Associate Professor, Department of Hospital Therapy with a course of Pharmacology

ul. Gor’kogo 95, Blagoveshchensk, 675006



E. Yu. Kochegarova
Federal State Budgetary Scientific Institution “Far Eastern Scientific Center of Physiology and Pathology of Respiration”

 

Ekaterina Yu. Kochegarova, Candidate of Medicine, lecturer

ul. Kalinina 22, Blagoveshchensk, 675004



A. M. Kulbaisov
Orenburg Regional Clinical Hospital No.2

Amyrzhan M. Kulbaisov, Candidate of Medicine, Head of the Department of Pulmonology

ul. Nevelskaya 24, Orenburg, 460000



I. V. Leshchenko
Federal State Budgetary Educational Institution of Higher Professional Education “Ural State Medical University” of the Ministry of Healthcare of the Russian Federation

Igor V. Leshchenko, Doctor of Medicine, Professor of the Department of Phthisiology and Pulmonology

ul. Repina 3, Еkaterinburg, 620028



S. V. Skal’skiy
“RZhD-Medicine” Omsk Private Clinical Hospital

Sergey V. Skal’skiy, Doctor of Medicine, Associate Professor, clinical pharmacologist

ul. Karbysheva 41, Omsk, 644020



D. A. Tikhanov
Saint-Petersburg Pokrovskaya City Hospital

Dmitriy A. Tikhanov, pulmonologis

Bolshoy prospekt 85, Saint-Petersburg, 199106



References

1. 2017 GINA Main Report. Global Initiative for Asthma. Available at: https://ginasthma.org/archived-reports/ [Accessed: May 27, 2022].

2. 2019 GINA Main Report. Global Initiative for Asthma. Available at: https://ginasthma.org/archived-reports/ [Accessed: May 27, 2022].

3. O’Byrne P.M., FitzGerald J.M., Zhong N. et al. The SYGMA programme of phase 3 trials to evaluate the efficacy and safety of budesonide/formoterol given “as needed” in mild asthma: Study protocols for two randomised controlled trials. Trials. 2017; 18 (1): 12. DOI: 10.1186/s13063-016-1731-4.

4. Suissa S., Ernst P., Boivin J.F. et al. A cohort analysis of excess mortality in asthma and the use of inhaled β-agonists. Am. J. Respir. Crit. Care Med. 1994; 149 (3, Pt 1): 604–610. DOI: 10.1164/ajrccm.149.3.8118625.

5. Nwaru B.I., Ekström M., Hasvold P. et al. Overuse of short-acting β2 -agonists in asthma is associated with increased risk of exacerbation and mortality: A nationwide cohort study of the global SABINA programme. Eur. Respir. J. 2020; 55 (4): 1901872. DOI: 10.1183/13993003.01872-2019.

6. Levy M.L. The national review of asthma deaths: What did we learn and what needs to change? Breathe (Sheff.). 2015; 11 (1): 15–24. DOI: 10.1183/20734735.008914.

7. O’Byrne P.M., Bisgaard H., Godard P.P. et al. Budesonide/formoterol combination therapy as both maintenance and reliever medication in asthma. Am. J. Respir. Crit. Care Med. 2005; 171 (2): 129–136. DOI: 10.1164/rccm.200407-884OC.

8. O’Byrne P.M., Jenkins C., Bateman E.D. The paradoxes of asthma management: time for a new approach? Eur. Respir. J. 2017; 50 (3): 1701103. DOI: 10.1183/13993003.01103-2017.

9. Beasley R., Holliday M., Reddel H.K. et al. Controlled trial of budesonide–formoterol as needed for mild asthma. N. Engl. J. Med. 2019; 380 (21): 2020–2030. DOI: 10.1056/nejmoa1901963.

10. O’Byrne P.M., FitzGerald J.M., Bateman E.D. et al. Inhaled combined budesonide–formoterol as needed in mild asthma. N. Engl. J. Med. 2018; 378 (20): 1865–1876. DOI: 10.1056/NEJMoa1715274.

11. Bateman E.D., Reddel H.K., O’Byrne P.M. et al. As-needed budesonide–formoterol versus maintenance budesonide in mild asthma. N. Engl. J. Med. 2018; 378 (20): 1877–1887. DOI: 10.1056/nejmoa1715275.

12. Reddel H.K., FitzGerald J.M., Bateman E.D. et al. GINA 2019: a fundamental change in asthma management: treatment of asthma with short-acting bronchodilators alone is no longer recommended for adults and adolescents. Eur. Respir. J. 2019; 53 (6): 1901046. DOI: 10.1183/13993003.01046-2019.

13. Cabrera C.S., Nan C., Lindarck N. et al. SABINA: global programme to evaluate prescriptions and clinical outcomes related to short-acting β2 -agonist use in asthma. Eur. Respir. J. 2020; 55 (2): 1901858. DOI: 10.1183/13993003.01858-2019.

14. Bateman E.D., Price D.B., Wang H.C. et al. Short-acting β2 -agonist prescriptions are associated with poor clinical outcomes of asthma: the multi-country, cross-sectional SABINA III study. Eur. Respir J. 2022; 59 (5): 2101402. DOI: 10.1183/13993003.01402-2021.

15. Avdeev S., Voznesenskiy N., Boldina M. et al. SABA overuse in Russia – burden and possible causes: an analysis of the Russian population in the SABINA III (SABA use in asthma) study. J. Asthma Allergy. 2022; 15: 371–379. DOI: 10.2147/JAA.S350393.

16. Janson С., Menzies-Gow А., Nan C. et al. SABINA: an overview of short-acting β2-agonist use in asthma in European countries. Adv. Ther. 2020; 37 (3): 1124–1135. DOI: 10.1007/s12325-01233-0.

17. Bloom C.I., Cabrera C., Arnetorp S. et al. Asthma-related health outcomes associated with short-acting β2 -agonist inhaler use: an observational UK study as part of the SABINA global program. Adv. Ther. 2020; 37 (10): 4190–4208. DOI: 10.1007/S12325-020-01444-5.

18. Di Marco F., D’Amato M., Lombardo F.P. et al. The burden of short-acting β2 -agonist use in asthma: Is there an Italian case? An update from SABINA program. Adv. Ther. 2021; 38 (7): 3816–3830. DOI: 10.1007/S12325-021-01772-0.

19. Nelson H.S., Weiss S.T., Bleecker E.K. et al. The salmeterol multicenter asthma research trial: a comparison of usual pharmacotherapy for asthma or usual pharmacotherapy plus salmeterol. Chest. 2006; 129 (1): 15–26. DOI: 10.1378/chest.129.1.15.

20. Aisanov Z., Avdeev S., Arkhipov V., Belevsky A. SYmbicort Given as needed in Mild Asthma (SYGMA study): a retrospective subanalysis of the Russian population. J. Asthma. 2022; 59 (5): 989–997. DOI: 10.1080/02770903.2021.1892753.

21. Aisanov Z.R., Avdeev S.N., Arkhipov V.V. et al. [Peculiarities of mild asthma in Russia: the results of SYGMA2 study]. Terapevticheskiy arkhiv. 2021; 93 (4): 449–455. DOI: 10.26442/00403660.2021.04.200812 (in Russian).

22. Paris J., Peterson E.L., Wells K. et al. Relationship between recent short-acting β-agonist use and subsequent asthma exacerbations. Ann. Allergy Asthma Immunol. 2008; 101 (5): 482–487. DOI: 10.1016/S1081-1206(10)60286-4.

23. Nasser S. An imperfect “PAST” lessons learned from the national review of asthma deaths (NRAD) UK. Respir Res. 2016; 17 (1): 87. DOI: 10.1186/s12931-016-0393-9.


Supplementary files

Review

For citations:


Avdeev S.N., Voznesenskiy N.A., Boldina N.V., Van’kova E.I., Zaykova-Khelimskaya I.V., Ignatova G.L., Kostina N.E., Kostrova I.V., Kochegarova E.Yu., Kulbaisov A.M., Leshchenko I.V., Skal’skiy S.V., Tikhanov D.A. Overuse of short-acting β2 -agonists in the Russian population with asthma: the persisting threat. PULMONOLOGIYA. 2022;32(5):661-669. (In Russ.) https://doi.org/10.18093/0869-0189-2022-32-5-661-669

Views: 3023


ISSN 0869-0189 (Print)
ISSN 2541-9617 (Online)