Related Experiment Videos
Asthma exacerbations during first therapy with long acting beta 2-agonists
C M Gerrits1, R M Herings, H G Leufkens
1Department of Pharmacoepidemiology & Pharmacotherapy, Utrecht Institute of Pharmaceutical Sciences (UIPS), Utrecht University.
Pharmacy World & Science : PWS
|July 31, 1999
Summary
Long-acting beta 2-agonists (LBA) may increase asthma exacerbation risk, particularly in new users. Caution is advised when initiating LBA therapy without prior anti-asthma treatment.
Area of Science:
- Pulmonology
- Pharmacology
- Epidemiology
Background:
- Long-acting beta 2-agonists (LBA) are widely used for asthma management.
- Concerns exist regarding the potential for LBA to increase asthma exacerbations (AE).
Purpose of the Study:
- To investigate if initiating LBA therapy elevates the risk of AE.
- To determine if AE risk associated with LBA initiation varies by asthma severity.
Main Methods:
- Retrospective cohort study using the PHARMO-RLS database (1992-1995).
- Included patients aged 5-49 initiating LBA therapy.
- AE proxies: short courses of oral glucocorticosteroids or antibiotics.
- Asthma severity assessed pre-LBA initiation.
Main Results:
- AE incidence increased significantly with severity.
- A modest increased risk of AE (RR 1.4) was observed in patients starting LBA without prior anti-asthma treatment.
- Patients using LBA as first-line therapy (6.9%) had a 40% higher risk of AE compared to the general LBA-using population.
Conclusions:
- Overall AE incidence did not change compared to the year before LBA initiation.
- LBA initiation as step-one therapy is associated with a higher AE risk, potentially due to confounding.
- Recommend caution when prescribing LBA to asthma patients not previously treated with other anti-asthma medications.