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Inhaled Corticosteroids May Decrease Death Risk

Kate Traynor

Researchers in Canada recently reported that children and adults with severe asthma who do not use inhaled corticosteroids are twice as likely to die from the disease as patients who use more than six inhalant canisters a year.

The study examined the relation between the use of low-dose inhaled corticosteroids and death in male and female asthma patients as young as 5 years old. People with severe asthma who stopped using their inhalers, or used them only irregularly, faced an increased risk of death, the researchers found. 

In the study, which appeared in the Aug. 3 issue of the New England Journal of Medicine, inhaled corticosteroid use in the 12 months before a patient died was compared to inhalant use by other asthma patients during the same year. 

Beclomethasone in 200-puff canisters, 50 mcg per puff, accounted for 93 percent of all inhaled corticosteroid prescriptions in the study. The authors stated that this low dose decreases the risk of death from asthma without causing adverse ocular effects in adults or decreasing growth in children. 

Two pulmonary physicians involved in the study identified 77 asthma-related deaths among 30,569 people listed in the Saskatchewan Health database who received at least three prescriptions for an antiasthma medication during a one-year period from 1975 through 1991. A continuous record of prescription use was available for 66 of these 77 patients. About 2,700 control patients with severe asthma were matched to this group. 

With each additional canister used by a patient, the risk of death from asthma decreased by 21 percent in the subsequent year and by 54 percent in the immediate six months. Only one patient who used more than five canisters in a year died from asthma. 

Death from asthma was most likely to occur within three months after a patient stopped using all inhalants. 

The study was supported in part by a grant from Boehringer Ingelheim GmBH, maker of a beclomethasone inhaler. The lead author for the article is a consultant for the company.