Use of salmeterol with and without concurrent use of inhaled corticosteroids and the risk of asthma-related hospitalization among patients with asthma

Meng Ting Wang, Grant H. Skrepnek, Edward P Armstrong, Duane L Sherrill, Robin B Harris, Cheng Liang Tsai, Daniel C Malone

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Rationale: Studies evaluating the safety of salmeterol are inconclusive, which might be the result from not taking into account the impact of concomitant inhaled corticosteroids (ICS). Objective: To study whether salmeterol use with and without concomitant ICS, respectively, was associated with an increased risk of asthma-related hospitalizations among patients with asthma. Methods: A case-control study nested within a cohort of patients with asthma, identified in the year 2000, over a 2-year period was conducted. Cases were subjects who had a first-time hospitalization for asthma in the year 2001, and were matched with up to five controls by age (± 5 years), sex, and number of asthma-related outpatient visits. Measurements: Hospitalizations and medication use were extracted from the MEDSTAT's MarketScan database. Main results: There were 333 cases of asthma-related hospitalizations and 1607 matched control subjects. Any use of salmeterol with concomitant ICS use during the prior year was associated with a 32% risk reduction for being hospitalized due to asthma (OR = 0.68; 95% CI = 0.48, 0.96). In the presence of concomitant ICS use, patients who either used salmeterol currently or used seven or more canisters of salmeterol during the prior year had 46% (OR = 0.54, 95% CI = 0.32, 0.92), and 59% (OR = 0.41, 95% CI = 0.21, 0.79) reductions in the risk of hospital admissions for asthma, respectively. Limitations: Though indirect measure of asthma severity was adjusted during the analyses, the lack of information on lung function might result in a selection bias. Additionally, only a small sample size of patients was found to use salmeterol without concomitant ICS use, and this introduced the issue of lack of power. Conclusions: Use of salmeterol in conjunction with ICS is associated with a decreased risk of hospital admission for asthma.

Original languageEnglish (US)
Pages (from-to)859-867
Number of pages9
JournalCurrent Medical Research and Opinion
Volume24
Issue number3
DOIs
StatePublished - Mar 2008

Fingerprint

Adrenal Cortex Hormones
Hospitalization
Asthma
Risk Reduction Behavior
Salmeterol Xinafoate
Selection Bias
Sample Size
Case-Control Studies
Outpatients
Databases
Safety
Lung

Keywords

  • Asthma
  • Drug safety
  • Hospitalization
  • Inhaled corticosteroids
  • Long-acting beta-agonists
  • Salmeterol

ASJC Scopus subject areas

  • Medicine(all)

Cite this

@article{f5851a68c0e24ae7a10be6d160209e0d,
title = "Use of salmeterol with and without concurrent use of inhaled corticosteroids and the risk of asthma-related hospitalization among patients with asthma",
abstract = "Rationale: Studies evaluating the safety of salmeterol are inconclusive, which might be the result from not taking into account the impact of concomitant inhaled corticosteroids (ICS). Objective: To study whether salmeterol use with and without concomitant ICS, respectively, was associated with an increased risk of asthma-related hospitalizations among patients with asthma. Methods: A case-control study nested within a cohort of patients with asthma, identified in the year 2000, over a 2-year period was conducted. Cases were subjects who had a first-time hospitalization for asthma in the year 2001, and were matched with up to five controls by age (± 5 years), sex, and number of asthma-related outpatient visits. Measurements: Hospitalizations and medication use were extracted from the MEDSTAT's MarketScan database. Main results: There were 333 cases of asthma-related hospitalizations and 1607 matched control subjects. Any use of salmeterol with concomitant ICS use during the prior year was associated with a 32{\%} risk reduction for being hospitalized due to asthma (OR = 0.68; 95{\%} CI = 0.48, 0.96). In the presence of concomitant ICS use, patients who either used salmeterol currently or used seven or more canisters of salmeterol during the prior year had 46{\%} (OR = 0.54, 95{\%} CI = 0.32, 0.92), and 59{\%} (OR = 0.41, 95{\%} CI = 0.21, 0.79) reductions in the risk of hospital admissions for asthma, respectively. Limitations: Though indirect measure of asthma severity was adjusted during the analyses, the lack of information on lung function might result in a selection bias. Additionally, only a small sample size of patients was found to use salmeterol without concomitant ICS use, and this introduced the issue of lack of power. Conclusions: Use of salmeterol in conjunction with ICS is associated with a decreased risk of hospital admission for asthma.",
keywords = "Asthma, Drug safety, Hospitalization, Inhaled corticosteroids, Long-acting beta-agonists, Salmeterol",
author = "Wang, {Meng Ting} and Skrepnek, {Grant H.} and Armstrong, {Edward P} and Sherrill, {Duane L} and Harris, {Robin B} and Tsai, {Cheng Liang} and Malone, {Daniel C}",
year = "2008",
month = "3",
doi = "10.1185/030079908X273020",
language = "English (US)",
volume = "24",
pages = "859--867",
journal = "Current Medical Research and Opinion",
issn = "0300-7995",
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TY - JOUR

T1 - Use of salmeterol with and without concurrent use of inhaled corticosteroids and the risk of asthma-related hospitalization among patients with asthma

AU - Wang, Meng Ting

AU - Skrepnek, Grant H.

AU - Armstrong, Edward P

AU - Sherrill, Duane L

AU - Harris, Robin B

AU - Tsai, Cheng Liang

AU - Malone, Daniel C

PY - 2008/3

Y1 - 2008/3

N2 - Rationale: Studies evaluating the safety of salmeterol are inconclusive, which might be the result from not taking into account the impact of concomitant inhaled corticosteroids (ICS). Objective: To study whether salmeterol use with and without concomitant ICS, respectively, was associated with an increased risk of asthma-related hospitalizations among patients with asthma. Methods: A case-control study nested within a cohort of patients with asthma, identified in the year 2000, over a 2-year period was conducted. Cases were subjects who had a first-time hospitalization for asthma in the year 2001, and were matched with up to five controls by age (± 5 years), sex, and number of asthma-related outpatient visits. Measurements: Hospitalizations and medication use were extracted from the MEDSTAT's MarketScan database. Main results: There were 333 cases of asthma-related hospitalizations and 1607 matched control subjects. Any use of salmeterol with concomitant ICS use during the prior year was associated with a 32% risk reduction for being hospitalized due to asthma (OR = 0.68; 95% CI = 0.48, 0.96). In the presence of concomitant ICS use, patients who either used salmeterol currently or used seven or more canisters of salmeterol during the prior year had 46% (OR = 0.54, 95% CI = 0.32, 0.92), and 59% (OR = 0.41, 95% CI = 0.21, 0.79) reductions in the risk of hospital admissions for asthma, respectively. Limitations: Though indirect measure of asthma severity was adjusted during the analyses, the lack of information on lung function might result in a selection bias. Additionally, only a small sample size of patients was found to use salmeterol without concomitant ICS use, and this introduced the issue of lack of power. Conclusions: Use of salmeterol in conjunction with ICS is associated with a decreased risk of hospital admission for asthma.

AB - Rationale: Studies evaluating the safety of salmeterol are inconclusive, which might be the result from not taking into account the impact of concomitant inhaled corticosteroids (ICS). Objective: To study whether salmeterol use with and without concomitant ICS, respectively, was associated with an increased risk of asthma-related hospitalizations among patients with asthma. Methods: A case-control study nested within a cohort of patients with asthma, identified in the year 2000, over a 2-year period was conducted. Cases were subjects who had a first-time hospitalization for asthma in the year 2001, and were matched with up to five controls by age (± 5 years), sex, and number of asthma-related outpatient visits. Measurements: Hospitalizations and medication use were extracted from the MEDSTAT's MarketScan database. Main results: There were 333 cases of asthma-related hospitalizations and 1607 matched control subjects. Any use of salmeterol with concomitant ICS use during the prior year was associated with a 32% risk reduction for being hospitalized due to asthma (OR = 0.68; 95% CI = 0.48, 0.96). In the presence of concomitant ICS use, patients who either used salmeterol currently or used seven or more canisters of salmeterol during the prior year had 46% (OR = 0.54, 95% CI = 0.32, 0.92), and 59% (OR = 0.41, 95% CI = 0.21, 0.79) reductions in the risk of hospital admissions for asthma, respectively. Limitations: Though indirect measure of asthma severity was adjusted during the analyses, the lack of information on lung function might result in a selection bias. Additionally, only a small sample size of patients was found to use salmeterol without concomitant ICS use, and this introduced the issue of lack of power. Conclusions: Use of salmeterol in conjunction with ICS is associated with a decreased risk of hospital admission for asthma.

KW - Asthma

KW - Drug safety

KW - Hospitalization

KW - Inhaled corticosteroids

KW - Long-acting beta-agonists

KW - Salmeterol

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