Document Detail


A cohort analysis of excess mortality in asthma and the use of inhaled beta-agonists.
MedLine Citation:
PMID:  8118625     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The association between the use of inhaled beta-agonists and the risk of death and near-death from asthma has previously been reported. It was based on a nested case-control study of 129 cases and 655 control subjects selected from a cohort of 12,301 users of asthma drugs followed during the period 1980 through 1987. In this paper we examine the question of asthma and non-asthma mortality using data from the entire cohort of 12,301 asthmatics. There were 46 asthma and 134 non-asthma deaths in this cohort, for which there were 47,842 person-years of follow-up. The overall rate of asthma death was 9.6 per 10,000 asthmatics per year. This rate varied significantly according to the use of fenoterol, albuterol, or oral corticosteroids in the prior 12 months and the number of asthma hospitalizations in the prior 2 years. The rate decreased significantly, by 0.6 asthma deaths per 10,000 asthmatics per year over the study period, after controlling for the effect of the four other risk factors. It also increased significantly with the use of all beta-agonists, and more so for fenoterol than for albuterol, although this difference was partly explained by the dose inequivalence of the two drugs. Change-point dose-response curves showed that the risk of asthma death began to escalate drastically at about 1.4 canisters (of 20,000 micrograms each) per month of inhaled beta-agonist, the recommended limit. For non-asthma death, the overall rate of 28 deaths per 10,000 asthmatics per year was not related to the use of inhaled beta-agonists.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
S Suissa; P Ernst; J F Boivin; R I Horwitz; B Habbick; D Cockroft; L Blais; M McNutt; A S Buist; W O Spitzer
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of respiratory and critical care medicine     Volume:  149     ISSN:  1073-449X     ISO Abbreviation:  Am. J. Respir. Crit. Care Med.     Publication Date:  1994 Mar 
Date Detail:
Created Date:  1994-04-06     Completed Date:  1994-04-06     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9421642     Medline TA:  Am J Respir Crit Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  604-10     Citation Subset:  AIM; IM    
Affiliation:
Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec.
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MeSH Terms
Descriptor/Qualifier:
Administration, Inhalation
Administration, Oral
Adolescent
Adrenal Cortex Hormones / administration & dosage
Adult
Albuterol / administration & dosage*,  adverse effects*
Asthma / drug therapy*,  mortality*
Cause of Death
Child
Child, Preschool
Dose-Response Relationship, Drug
Drug Therapy, Combination
Female
Fenoterol / administration & dosage*,  adverse effects*
Follow-Up Studies
Hospitalization / statistics & numerical data
Humans
Linear Models
Male
Middle Aged
Odds Ratio
Population Surveillance*
Risk Factors
Saskatchewan / epidemiology
Socioeconomic Factors
Survival Analysis
Chemical
Reg. No./Substance:
0/Adrenal Cortex Hormones; 13392-18-2/Fenoterol; 18559-94-9/Albuterol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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