RISK OF FATAL AND NEAR-FATAL ASTHMA IN RELATION TO INHALED CORTICOSTEROID USE

[摘要] Purpose of the Study. To examine the relationship between patterns of use of inhaled beclomethasone dipropionate (50 µg/puff) and the risk of fatal and near-fatal asthma.Study Population. A cohort of 12 301 individuals aged 5 to 54 years was identified from the residents of Saskatchewan, Canada. These were asthma patients dispensed ten or more prescriptions for drugs in common use for asthma treatment from 1978 to 1987.Methods. A case control analysis was performed. Cases were defined as persons within the cohort who met predetermined criteria for having fatal or near-fatal asthma. These were matched with 655 controls within the cohort who had asthma, but no fatality or near-fatality. The subjects were then stratified as to their use of inhaled beclomethasone dipropionate for the 12 months prior to the fatal or near-fatal event, or index date for controls. Each person's use of inhaled beclomethasone was divided into three groups: no medication in the prior 12 months, less than 12 units in the previous 12 months, or greater than 12 units over the previous 12 months.Findings. Of the 784 cases and controls, 269 had been dispensed inhaled beclomethasone in the prior 12 months. Of these, 232 had been dispensed less than 12 units, and only 37 had been dispensed 12 or more units. Matched odds ratio adjusted for use of other medications and number of hospitalizations for asthma showed a 1.6 times increased risk of fatal and near-fatal asthma in the group using less than 12 units of beclomethasone per year as compared to the group using none, but this did not meet statistical significance.

[学科分类] 儿科学