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Inhalation OctOber 2022 39 In the Journal of Allergy and Clinical Immunology: In Practice SABINA data from Europe and North America, published in the Journal of Allergy and Clinical Im- munology: In Practice showed that approximately 40% of patients across all asthma severities were prescribed or received three or more SABA inhalers per year. is was associated with a 32% increase in risk of severe asthma exacerba- tions compared to patients receiv- ing one or two inhalers per year, monology, Department of Med- icine, University of Cape Town, Cape Town, South Africa, and lead author of the European Respi- ratory Journal article. "It brings into focus the need for renewed efforts to reduce over-reliance on SABAs and the adoption of treat- ment strategies that provide both quick symptom relief and an anti-inflammatory effect." children, worldwide, who have asthma and are at risk of severe exacerbations, regardless of their disease severity, adherence to treat- ment or level of control. Further, an estimated 176 million asthma exacerbations occur globally per year, which are physically threat- ening and emotionally significant for many patients and can be fatal. Consistent findings, regardless of country or asthma severity AstraZeneca discussed the overall results noting the multi-country analyses of more than one million patients with asthma showed use of three or more SABA inhalers per year was associated with an increased risk of severe exacerba- tions and a lower likelihood of controlled asthma. e findings were consistent regardless of coun- try and asthma severity. In addi- tion, the risk of exacerbation was independent of maintenance ther- apy containing inhaled corticoste- roids, which they stated further highlighted the need for contin- ued efforts to improve asthma management. In the European Respiratory Journal SABINA data from 24 countries across five continents demon- strated that 38% of patients were prescribed three or more SABA relievers a year. is was associated with an increasing rate of severe exacerbations and a lower like- lihood of satisfactory symptom control. Patients prescribed three to five SABA relievers a year had 40% more severe exacerbations compared to patients receiving one or two inhalers per year. is percentage rose further in con- junction with increasing numbers of SABA prescriptions. "e SABINA Program shows that the overuse of SABA is a global problem of considerable magni- tude, associated with negative out- comes of asthma treatment," said Eric D. Bateman, Division of Pul-