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Bronchodilator treatment and deaths from asthma: case-control study
H Ross Anderson1, Jon G Ayres, Patricia M Sturdy
1Department of Community Health Sciences, St George's Hospital Medical School, London SW17 0RE. r.anderson@sghms.ac.uk
BMJ (Clinical Research Ed.)
|December 25, 2004
Summary
Asthma deaths were not linked to recent bronchodilator use. However, long-term use of short-acting beta2 agonists was associated with increased asthma mortality in older adults.
Area of Science:
- Pulmonary Medicine
- Clinical Epidemiology
Background:
- Asthma mortality remains a significant public health concern.
- The role of bronchodilator therapy in asthma exacerbations and mortality requires further investigation.
Purpose of the Study:
- To examine the association between bronchodilator treatment and asthma-related deaths.
- To explore potential links between different classes of asthma medications and mortality risk.
Main Methods:
- A case-control study was conducted involving 532 asthma deaths and 532 matched controls.
- Data were collected from 33 health authorities in Great Britain.
- Odds ratios were calculated for bronchodilator prescriptions, with adjustments for various clinical factors.
Main Results:
- No significant association was found between recent bronchodilator use (4-12 months prior) and asthma deaths.
- Long-term use (1-5 years prior) of short-acting beta2 agonists showed a positive association with mortality (OR 2.05).
- Antibiotic use was inversely associated with mortality (OR 0.59), particularly in younger individuals.
Conclusions:
- No evidence suggests adverse effects on mortality from medium to long-term use of inhaled long-acting beta2 agonists.
- The association between short-acting beta2 agonists and mortality may have multiple explanations, not solely a direct adverse effect.