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Los esteroides inhalados y el riesgo de hospitalización por asma
J G Donahue1, S T Weiss, J M Livingston
1Channing Laboratory, Boston, MA, USA. Jim.Donhaue@channing.harvard.edu
JAMA
|March 19, 1997
Resumen
Los tratamientos antiinflamatorios para el asma, específicamente los esteroides inhalados y cromolyn, reducen significativamente el riesgo de hospitalizaciones por asma. Por el contrario, el aumento del uso de beta-agonistas se relacionó con un mayor riesgo de hospitalización.
Área de la Ciencia:
- Medicina Pulmonar La medicina pulmonar es el tratamiento de las enfermedades pulmonares.
- Farmacología Farmacología.
Sus antecedentes:
- Las exacerbaciones del asma con frecuencia conducen a la hospitalización, lo que representa una carga significativa para los pacientes y los sistemas de salud.
- La identificación de tratamientos efectivos para prevenir las hospitalizaciones relacionadas con el asma es crucial para mejorar los resultados de los pacientes.
Objetivo del estudio:
- Evaluar la efectividad de los medicamentos antiinflamatorios para el asma en la reducción del riesgo de hospitalización por asma.
- Para comparar los efectos protectores de los corticosteroides inhalados y cromolyn contra las exacerbaciones de asma.
Principales métodos:
- Estudio de cohorte retrospectivo utilizando datos de una organización de mantenimiento de la salud (HMO) en el este de Massachusetts.
- Análisis de registros médicos computarizados de 16.941 personas diagnosticadas con asma entre octubre de 1991 y septiembre de 1994.
- Ajuste estadístico para factores que incluyen el uso de beta-agonistas, la edad, la raza, otros medicamentos para el asma y la utilización de la atención médica.
Principales resultados:
- El uso de esteroides inhalados se asoció con una reducción del 50% en el riesgo de hospitalización por asma (riesgo relativo [RR], 0,5; intervalo de confianza del 95% [IC], 0,4-0,6).
- Cromolyn también demostró un riesgo reducido de hospitalización, especialmente en niños (RR, 0,8; IC del 95%, 0,7-0,9).
- El aumento del uso de beta-agonistas se correlacionó con un mayor riesgo de hospitalización, incluso después de tener en cuenta otras variables.
Conclusiones:
- Los corticosteroides inhalados y cromolyn proporcionan una protección significativa contra las exacerbaciones del asma que requieren hospitalización.
- Estos hallazgos apoyan el uso de esteroides inhalados para pacientes con asma que con frecuencia usan beta-agonistas para el control de los síntomas.
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