Short-acting beta2 agonists linked with asthma deaths
Use of short-acting beta2 agonists is associated with a modest increase in risk of death in people with asthma, say researchers. However, they warn that the association does not prove that this class of drugs is responsible.
The researchers collected data on all asthma deaths that occurred from
1994 to 1998 within 33 health authorities and health boards across Great
Britain. They compared data from 532 patients who died from asthma with
those from an equal number of age-matched controls who had been admitted
to hospital with asthma.
The researchers observed that use of short-acting beta2 agonists within
the one- to five-year period before death or admission to hospital was
associated with a doubling of the risk of death (odds ratio 2.05, 95
per cent confidence interval 1.26 to 3.33). They suggest that the increased
risk of death could be explained by reasons other than an adverse effect
of the drug itself, for example: more severe disease; treatment for associated
chronic obstructive pulmonary disease; a tendency for patients whose
disease is not responding to receive a wider range of treatments; and
lack of appropriate asthma care. “Considering the modest increase
in risk, and the potential for other explanations, we conclude that the
evidence for a direct adverse effect of short-acting beta2 agonists is
inconclusive but remains a matter of concern,” they
say.
There was no positive association between use of long-acting beta2 agonists,
which were commonly prescribed, and death. In addition, there was no
convincing evidence that inhaled corticosteroids were associated with
an increased risk of death (BMJ 2005;330:117). |
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