In a new editorial published in the European Respiratory Journal, Matthew Martin and Tim Harrison discuss whether the time has come to move away from short-acting beta-agonist (SABA) inhalers in asthma management.
The editorial considers studies that assess the efficacy of SABAs in the management and control of asthma, and discusses the merits and practical concerns related to alternative methods of treatment, such as low dose inhaled corticosteroids and combined beclomethasone/salbutamol inhalers, among others.
The authors say that persistently high levels of poor asthma control and ongoing asthma deaths in the 21st century are a growing concern, and argue that the widespread use and overuse of short-SABAs are a major part of the problem.
They also argue that SABAs simply mask ongoing airway inflammation by providing symptom relief, and that SABAs adversely affect adherence with anti-inflammatory treatment. Further, they suggest that beta-agonists should always be combined with additional corticosteroid in the treatment of confirmed asthma.
The authors conclude that they believe it is time to move asthma management away from SABAs, but they caution that further data is urgently required to make this a practical ambition.