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This website is intended for UK Healthcare Professionals only. Other UK residents please visit astrazeneca.co.uk
SABA (short-acting beta-agonist) inhaler over-reliance is common in asthma patients in the UK1,2 because when symptoms worsen, many turn to their SABA for fast relief (onset within 5 minutes).1,3,4 But SABAs don’t address the root cause of asthma. They don’t have any anti-inflammatory effect, so don’t treat the underlying inflammation responsible for asthma symptoms.5 This over-reliance is an entirely preventable reason for asthma exacerbations and deaths.1,2
SABA over-reliance is a problem that’s been around for some time.2 Outcomes from the National Review of Asthma Deaths (NRAD) which reviewed 2012–2013 data, showed excessive prescribing of SABA inhalers and in the year prior to death, SABA prescribing data was available for 165 patients and found that:2
(92/165) had been prescribed
>6 SABA inhalers
(65/165) had been prescribed >12
SABA inhalers
(6/165) had been prescribed >50
SABA inhalers
Nothing much has changed. This over-reliance on SABAs continues to be an issue today.1
Patients who take 3 or more SABA inhalers compared to 0–2 a year have approximately twice as many exacerbations*^ regardless of asthma severity.1
^Calculated from the mean number of exacerbations in a retrospective observational study (SABA use IN Asthma; SABINA) in the UK using data from the Clinical Practice Research Datalink (CRPD) database between 2007-2017 (n=574,913 of which 284,816 were adults who were accessed for outcomes). The rate was extrapolated to an adult asthma population of 4.3 million patients.14
*An exacerbation was defined as either a short course of OCS (GP managed exacerbation), an Accident and Emergency visit for asthma, a hospital admission or death secondary to asthma.1
**Over-reliance is defined as ≥ 3 inhalers/year (pMDI and DPI).6 This figure is extracted from the SABINA UK study1, and extrapolated to the UK adult asthma population.
We know many patients are in the habit of relying on their SABA inhaler for fast relief.4,5,7 However, this continued need for fast relief results in over-reliance on SABAs and puts asthma patients at risk of preventable exacerbations (asthma attacks).2
At its simplest, this ‘quick fix’ is placing asthma patients who require optimised anti-inflammatory therapy, at risk.2
Helping patients to reduce SABA inhaler use could reduce their risk of exacerbations and potentially lead to a better quality of life.8,9
Two simple questions can be all it takes to uncover SABA over-reliance and determine your next steps:
Question 1: How often have your patients used their SABA in the past 4 weeks?
If your patients are prescribed more than 1 SABA inhaler per month, it could be a sign of poor control.10
Question 2: How many SABA inhalers have your patients used this year?
There is strong evidence that use of three or more SABA inhalers per year increases the risk of exacerbations compared to 0-2 SABAs per year.1
Symbicort® Reliever Therapy (Turbohaler® 200/6)
For asthma patients
(12 years and older)12
Symbicort® Maintenance And Reliever Therapy (MART)
Symbicort® Turbohaler® 100/6 for MART in asthma patients aged 6 years and older or Turbohaler® 200/6 for asthma patients 12 years and older.11,12
Symbicort® Turbohaler® Maintenance Therapy
Symbicort® Turbohaler® 100/6 for asthma patients (6 years and older), 200/6 for asthma patients (12 years and older) and 400/12 for asthma patients (12 years and older).11-13
A&E, Accident and Emergency; BTS, British Thoracic Society; SABA, short-acting beta-agonist; CPRD, Clinical Practice Research Database; DPI, dry powder inhaler; GP, general practitioner; HES, Hospital Episode Statistics; MART, maintenance and reliever therapy; NRAD, National Review of Asthma Deaths; OCS, oral corticosteroids; ONS, Office for National Statistics.
GB-66412 I DOP: September 2025
Adverse events should be reported. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. Adverse events should also be reported to AstraZeneca by visiting https://contactazmedical.astrazeneca.com/ or by calling 0800 783 0033.
This website was created for UK HCPs and has been designed to provide information to educate, empower and enable them in the great work they are doing for patients across a range of therapy areas. This website is intended for doctors, nurses, and pharmacists in the UK. Other UK residents please visit astrazeneca.co.uk.
