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Decrease in asthma mortality rate in Israel from 1991-1995: is it related to increased use of inhaled
M Goldman1, M Rachmiel, L Gendler
1Department of Pediatrics and the Pulmonary and Allergy Institute, Assaf Harofeh Medical Center, Zerifin, Israel.
The Journal of Allergy and Clinical Immunology
|January 12, 2000
Summary
Asthma mortality rates in Israel decreased significantly between 1991-1995, coinciding with increased use of inhaled corticosteroids (ICSs). This suggests improved anti-inflammatory treatment may reduce asthma deaths.
Area of Science:
- Pulmonary Medicine
- Epidemiology
- Pharmacotherapy
Background:
- Asthma mortality rates (AMRs) have risen in developed nations, including Israel, with underlying reasons unclear.
- Recent trends suggest a potential shift in AMR patterns.
Purpose of the Study:
- To compare AMR in Israel during 1991-1995 with the preceding decade.
- To investigate the correlation between AMR and the usage of inhaled corticosteroids (ICSs) and beta(2)-agonists.
Main Methods:
- Analysis of statistical data on AMR in Israel from 1981-1995.
- Comparison of 5- and 10-year periods (1981-1990 vs. 1991-1995).
- Extraction of ICS and beta(2)-agonist sales data from marketing reports.
Main Results:
- Mean AMR in the 5-34 year age group decreased from 0.393 in 1981-1990 to 0.202 in 1991-1995 (P=.03).
- Mean ICS sales rates increased significantly from 21.70 to 190.45 units per 100,000 population (P<.05).
- A significant negative correlation (r=-0.631, P=.016) was found between ICS sales and AMR; beta(2)-agonist sales remained stable.
Conclusions:
- A notable decrease in AMRs was observed in Israel during 1991-1995.
- The decline in AMRs paralleled increased ICS sales, suggesting improved anti-inflammatory management.
- This study indicates the potential for reducing AMRs through enhanced medical treatment, even in countries with initially low rates.
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