SABAs as Reliever Medications in Asthma Management: Evidence-Based Science

Israel Amirav, Gabriel Garcia, Bao Khac Le, Paulina Barria, Gur Levy, Bhumika Aggarwal, Kyle Fahrbach, Amber Martin, Abhay Phansalkar, Thitiwat Sriprasart

Research output: Contribution to journalComment/debate

1 Scopus citations


The role of as-needed inhaled short-acting β2-agonists (SABAs) in the management of asthma has become a subject of debate due to differing opinions in the professional community relating to the use of SABAs. In this article, we summarize the current position of SABAs when used as reliever medications and examine the challenges to appropriate use including a critique of the data that have led to the condemnation of SABA used as a reliever. We consider the evidence for the appropriate use of SABA as a reliever together with practical solutions to ensure such use, including identifying patients at risk of misusing their SABA relievers and managing issues of inhaler technique and treatment adherence. We conclude that inhaled corticosteroid (ICS)-based maintenance treatment with SABA used as-needed as a reliever is an effective and safe treatment for patients with asthma, with no scientific evidence of a causal link between SABA use as a reliever and mortality or serious adverse events (including exacerbations). Increased SABA use warns of a deterioration in asthma control, and patients at risk of misusing their ICS and SABA medication should be rapidly identified to ensure they are receiving adequate ICS-based controller therapy. Appropriate use of ICS-based controller therapy and as-needed SABA should be encouraged and promoted with educational activities.

Original languageEnglish
Pages (from-to)2927-2943
Number of pages17
JournalAdvances in Therapy
Issue number7
StatePublished - Jul 2023
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2023, The Author(s).


  • As-needed reliever
  • Asthma management
  • SABA
  • Scientific evidence
  • Short-acting β-agonists


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