Manifesto on the overuse of SABA in the management of asthma: new approaches and new strategies

Giorgio Walter Canonica, Pierluigi Paggiaro, Francesco Blasi, Antonino Musarra, Luca Richeldi, Andrea Rossi, Alberto Papi

Research output: Contribution to journalArticlepeer-review


The risks of overusing short-acting β2-agonists (SABA), including an increase in asthma-related deaths, are many and well known. The Global Initiative on Asthma (GINA) 2019 and 2020 updates recommend as-needed inhaled corticosteroid (ICS)/formoterol as the preferred rescue medication in mild asthma as monotherapy and also in moderate to severe asthma when the maintenance and reliever therapy (MART) strategy is used. Using SABA for symptom relief, however, was the standard of treatment for many years, and consequently this practice persists, particularly in patients not taking ICS regularly. Here, we examine the rationale for this shift from a long-standing recommendation for as-needed SABA treatment to the use of as-needed ICS/formoterol and consider clinical evidence on strategies for asthma treatment and patient management.

Original languageEnglish
Article number17534666211042534
JournalTherapeutic Advances in Respiratory Disease
Publication statusPublished - Oct 1 2021


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