Risk of Fatal and Near-Fatal Asthma in Relation to Inhaled Corticosteroid Use

Pierre Ernst, Walter O. Spitzer, Samy Suissa, Donald Cockcroft, Brian Habbick, Ralph I. Horwitz, Jean Francois Boivin, Mary McNutt, A (Sonia) Buist

Research output: Contribution to journalArticle

209 Citations (Scopus)

Abstract

Objective.—To examine the relationship between patterns of use of inhaled beclomethasone dipropionate and the risk of fatal and near-fatal asthma. Design.—Nested case-control analysis of a historical cohort; a further analysis. Setting.—The 12 301 residents of Saskatchewan aged 5 to 54 years who were dispensed 10 or more asthma drugs from 1978 to 1987. Patients.—The 129 persons who experienced asthma death (n=44) and near-death (n=85) and their 655 controls matched as to age and date of entry into the cohort, with the additional matching criteria of at least one hospitalization for asthma in the prior 2 years, region of residence, and having received social assistance. Main Outcome.—Life-threatening attacks of asthma defined as death due to asthma or the occurrence of hypercarbia, intubation, and mechanical ventilation during an acute attack of asthma. Results.—After accounting for the risk associated with use of other medications and adjustment for markers of risk of adverse events related to asthma, subjects who had been dispensed, on average, one or more metered-dose inhalers of beclomethasone per month over a 1-year period had a significantly lower risk of fatal and near-fatal asthma (odds ratio, 0.1; 95% confidence interval, 0.02 to 0.6). Conclusion.—These data support recent guidelines from several countries that recommend the use of inhaled corticosteroids in moderate and severe asthma.

Original languageEnglish (US)
Pages (from-to)3462-3464
Number of pages3
JournalJAMA - Journal of the American Medical Association
Volume268
Issue number24
DOIs
StatePublished - Dec 23 1992

Fingerprint

Adrenal Cortex Hormones
Asthma
Beclomethasone
Saskatchewan
Risk Adjustment
Metered Dose Inhalers
Hypercapnia
Artificial Respiration
Intubation
Hospitalization
Odds Ratio
Guidelines
Confidence Intervals
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Risk of Fatal and Near-Fatal Asthma in Relation to Inhaled Corticosteroid Use. / Ernst, Pierre; Spitzer, Walter O.; Suissa, Samy; Cockcroft, Donald; Habbick, Brian; Horwitz, Ralph I.; Boivin, Jean Francois; McNutt, Mary; Buist, A (Sonia).

In: JAMA - Journal of the American Medical Association, Vol. 268, No. 24, 23.12.1992, p. 3462-3464.

Research output: Contribution to journalArticle

Ernst, P, Spitzer, WO, Suissa, S, Cockcroft, D, Habbick, B, Horwitz, RI, Boivin, JF, McNutt, M & Buist, AS 1992, 'Risk of Fatal and Near-Fatal Asthma in Relation to Inhaled Corticosteroid Use', JAMA - Journal of the American Medical Association, vol. 268, no. 24, pp. 3462-3464. https://doi.org/10.1001/jama.1992.03490240070039
Ernst, Pierre ; Spitzer, Walter O. ; Suissa, Samy ; Cockcroft, Donald ; Habbick, Brian ; Horwitz, Ralph I. ; Boivin, Jean Francois ; McNutt, Mary ; Buist, A (Sonia). / Risk of Fatal and Near-Fatal Asthma in Relation to Inhaled Corticosteroid Use. In: JAMA - Journal of the American Medical Association. 1992 ; Vol. 268, No. 24. pp. 3462-3464.
@article{35bf68939b7341bd8537cdd621cdfb45,
title = "Risk of Fatal and Near-Fatal Asthma in Relation to Inhaled Corticosteroid Use",
abstract = "Objective.—To examine the relationship between patterns of use of inhaled beclomethasone dipropionate and the risk of fatal and near-fatal asthma. Design.—Nested case-control analysis of a historical cohort; a further analysis. Setting.—The 12 301 residents of Saskatchewan aged 5 to 54 years who were dispensed 10 or more asthma drugs from 1978 to 1987. Patients.—The 129 persons who experienced asthma death (n=44) and near-death (n=85) and their 655 controls matched as to age and date of entry into the cohort, with the additional matching criteria of at least one hospitalization for asthma in the prior 2 years, region of residence, and having received social assistance. Main Outcome.—Life-threatening attacks of asthma defined as death due to asthma or the occurrence of hypercarbia, intubation, and mechanical ventilation during an acute attack of asthma. Results.—After accounting for the risk associated with use of other medications and adjustment for markers of risk of adverse events related to asthma, subjects who had been dispensed, on average, one or more metered-dose inhalers of beclomethasone per month over a 1-year period had a significantly lower risk of fatal and near-fatal asthma (odds ratio, 0.1; 95{\%} confidence interval, 0.02 to 0.6). Conclusion.—These data support recent guidelines from several countries that recommend the use of inhaled corticosteroids in moderate and severe asthma.",
author = "Pierre Ernst and Spitzer, {Walter O.} and Samy Suissa and Donald Cockcroft and Brian Habbick and Horwitz, {Ralph I.} and Boivin, {Jean Francois} and Mary McNutt and Buist, {A (Sonia)}",
year = "1992",
month = "12",
day = "23",
doi = "10.1001/jama.1992.03490240070039",
language = "English (US)",
volume = "268",
pages = "3462--3464",
journal = "JAMA - Journal of the American Medical Association",
issn = "0002-9955",
publisher = "American Medical Association",
number = "24",

}

TY - JOUR

T1 - Risk of Fatal and Near-Fatal Asthma in Relation to Inhaled Corticosteroid Use

AU - Ernst, Pierre

AU - Spitzer, Walter O.

AU - Suissa, Samy

AU - Cockcroft, Donald

AU - Habbick, Brian

AU - Horwitz, Ralph I.

AU - Boivin, Jean Francois

AU - McNutt, Mary

AU - Buist, A (Sonia)

PY - 1992/12/23

Y1 - 1992/12/23

N2 - Objective.—To examine the relationship between patterns of use of inhaled beclomethasone dipropionate and the risk of fatal and near-fatal asthma. Design.—Nested case-control analysis of a historical cohort; a further analysis. Setting.—The 12 301 residents of Saskatchewan aged 5 to 54 years who were dispensed 10 or more asthma drugs from 1978 to 1987. Patients.—The 129 persons who experienced asthma death (n=44) and near-death (n=85) and their 655 controls matched as to age and date of entry into the cohort, with the additional matching criteria of at least one hospitalization for asthma in the prior 2 years, region of residence, and having received social assistance. Main Outcome.—Life-threatening attacks of asthma defined as death due to asthma or the occurrence of hypercarbia, intubation, and mechanical ventilation during an acute attack of asthma. Results.—After accounting for the risk associated with use of other medications and adjustment for markers of risk of adverse events related to asthma, subjects who had been dispensed, on average, one or more metered-dose inhalers of beclomethasone per month over a 1-year period had a significantly lower risk of fatal and near-fatal asthma (odds ratio, 0.1; 95% confidence interval, 0.02 to 0.6). Conclusion.—These data support recent guidelines from several countries that recommend the use of inhaled corticosteroids in moderate and severe asthma.

AB - Objective.—To examine the relationship between patterns of use of inhaled beclomethasone dipropionate and the risk of fatal and near-fatal asthma. Design.—Nested case-control analysis of a historical cohort; a further analysis. Setting.—The 12 301 residents of Saskatchewan aged 5 to 54 years who were dispensed 10 or more asthma drugs from 1978 to 1987. Patients.—The 129 persons who experienced asthma death (n=44) and near-death (n=85) and their 655 controls matched as to age and date of entry into the cohort, with the additional matching criteria of at least one hospitalization for asthma in the prior 2 years, region of residence, and having received social assistance. Main Outcome.—Life-threatening attacks of asthma defined as death due to asthma or the occurrence of hypercarbia, intubation, and mechanical ventilation during an acute attack of asthma. Results.—After accounting for the risk associated with use of other medications and adjustment for markers of risk of adverse events related to asthma, subjects who had been dispensed, on average, one or more metered-dose inhalers of beclomethasone per month over a 1-year period had a significantly lower risk of fatal and near-fatal asthma (odds ratio, 0.1; 95% confidence interval, 0.02 to 0.6). Conclusion.—These data support recent guidelines from several countries that recommend the use of inhaled corticosteroids in moderate and severe asthma.

UR - http://www.scopus.com/inward/record.url?scp=0027055869&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0027055869&partnerID=8YFLogxK

U2 - 10.1001/jama.1992.03490240070039

DO - 10.1001/jama.1992.03490240070039

M3 - Article

C2 - 1460737

AN - SCOPUS:0027055869

VL - 268

SP - 3462

EP - 3464

JO - JAMA - Journal of the American Medical Association

JF - JAMA - Journal of the American Medical Association

SN - 0002-9955

IS - 24

ER -