Asthma drug use and the development of Churg-Strauss syndrome (CSS)

Leslie R. Harrold, M. Kay Patterson, Susan E. Andrade, Timothy Dube, Alan S. Go, A (Sonia) Buist, K. Arnold Chan, Peter F. Weller, Michael E. Wechsler, Robert A. Yood, Kourtney J. Davis, Richard Platt, Alexander M. Walker

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

Purpose: Case reports suggest that leukotriene modifier use may be associated with the onset of Churg-Strauss syndrome (CSS). Using pooled data from two nested case-control studies, we examined the association between asthma drug use and the development of CSS. Methods: The study was performed in three US managed care organizations and a US national health plan with chart access and complete electronic pharmacy data, with a covered population of 13.9 million. There were 47 cases of possible or definite CSS and 4700 asthma drug user controls identified between January 1, 1995 and December 31, 2002. We examined exposure to asthma drugs in cases and controls, including leukotriene modifiers (6 cases and 202 controls), in the two to 6 months prior to the onset of adjudicated CSS. Results: While the crude association between use of leukotriene modifiers and CSS was strong (odds ratio (OR) 4.00, 95% confidence interval (CI): 1.49-10.60), in a multivariable analysis controlling for use of oral corticosteroids, inhaled corticosteroids, and number of categories of asthma drugs dispensed, there was no significant association (OR 1.32, 95% CI: 0.44-3.96). Use of inhaled and oral corticosteroids, evaluated as markers of asthma severity, were associated with CSS (OR 3.07, 95% CI: 1.34-7.03 and OR 5.36, 95% CI: 2.51-11.45, respectively). Conclusions: No association was found between CSS and leukotriene modifiers after controlling for asthma drug use However, it is not possible to rule out modest associations with asthma treatments given CSS is so rare and so highly correlated with asthma severity, suggesting further investigation is warranted.

Original languageEnglish (US)
Pages (from-to)620-626
Number of pages7
JournalPharmacoepidemiology and Drug Safety
Volume16
Issue number6
DOIs
StatePublished - Jun 2007
Externally publishedYes

Fingerprint

Churg-Strauss Syndrome
Asthma
Leukotrienes
Pharmaceutical Preparations
Odds Ratio
Confidence Intervals
Adrenal Cortex Hormones
Drug and Narcotic Control
Managed Care Programs
Drug Users
Case-Control Studies
Organizations
Health

Keywords

  • Asthma
  • Case-control study
  • Churg-Strauss sydrome
  • Drug therapies

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology, Toxicology and Pharmaceutics(all)

Cite this

Harrold, L. R., Patterson, M. K., Andrade, S. E., Dube, T., Go, A. S., Buist, A. S., ... Walker, A. M. (2007). Asthma drug use and the development of Churg-Strauss syndrome (CSS). Pharmacoepidemiology and Drug Safety, 16(6), 620-626. https://doi.org/10.1002/pds.1353

Asthma drug use and the development of Churg-Strauss syndrome (CSS). / Harrold, Leslie R.; Patterson, M. Kay; Andrade, Susan E.; Dube, Timothy; Go, Alan S.; Buist, A (Sonia); Chan, K. Arnold; Weller, Peter F.; Wechsler, Michael E.; Yood, Robert A.; Davis, Kourtney J.; Platt, Richard; Walker, Alexander M.

In: Pharmacoepidemiology and Drug Safety, Vol. 16, No. 6, 06.2007, p. 620-626.

Research output: Contribution to journalArticle

Harrold, LR, Patterson, MK, Andrade, SE, Dube, T, Go, AS, Buist, AS, Chan, KA, Weller, PF, Wechsler, ME, Yood, RA, Davis, KJ, Platt, R & Walker, AM 2007, 'Asthma drug use and the development of Churg-Strauss syndrome (CSS)', Pharmacoepidemiology and Drug Safety, vol. 16, no. 6, pp. 620-626. https://doi.org/10.1002/pds.1353
Harrold, Leslie R. ; Patterson, M. Kay ; Andrade, Susan E. ; Dube, Timothy ; Go, Alan S. ; Buist, A (Sonia) ; Chan, K. Arnold ; Weller, Peter F. ; Wechsler, Michael E. ; Yood, Robert A. ; Davis, Kourtney J. ; Platt, Richard ; Walker, Alexander M. / Asthma drug use and the development of Churg-Strauss syndrome (CSS). In: Pharmacoepidemiology and Drug Safety. 2007 ; Vol. 16, No. 6. pp. 620-626.
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abstract = "Purpose: Case reports suggest that leukotriene modifier use may be associated with the onset of Churg-Strauss syndrome (CSS). Using pooled data from two nested case-control studies, we examined the association between asthma drug use and the development of CSS. Methods: The study was performed in three US managed care organizations and a US national health plan with chart access and complete electronic pharmacy data, with a covered population of 13.9 million. There were 47 cases of possible or definite CSS and 4700 asthma drug user controls identified between January 1, 1995 and December 31, 2002. We examined exposure to asthma drugs in cases and controls, including leukotriene modifiers (6 cases and 202 controls), in the two to 6 months prior to the onset of adjudicated CSS. Results: While the crude association between use of leukotriene modifiers and CSS was strong (odds ratio (OR) 4.00, 95{\%} confidence interval (CI): 1.49-10.60), in a multivariable analysis controlling for use of oral corticosteroids, inhaled corticosteroids, and number of categories of asthma drugs dispensed, there was no significant association (OR 1.32, 95{\%} CI: 0.44-3.96). Use of inhaled and oral corticosteroids, evaluated as markers of asthma severity, were associated with CSS (OR 3.07, 95{\%} CI: 1.34-7.03 and OR 5.36, 95{\%} CI: 2.51-11.45, respectively). Conclusions: No association was found between CSS and leukotriene modifiers after controlling for asthma drug use However, it is not possible to rule out modest associations with asthma treatments given CSS is so rare and so highly correlated with asthma severity, suggesting further investigation is warranted.",
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