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
AU - Sherrill, Duane L.
AU - Harris, Robin B.
AU - Tsai, Cheng Liang
AU - Malone, Daniel C.
N1 - Funding Information:
Declaration of interest: This research was funded by a graduate stipend from the Ministry of Defense, Taiwan, for MTW. The authors thank MEDSTAT for providing free access to the two-year Medstat MarketScan claims database through the MarketScan Dissertation Support Program. DCM served on a cardiovascular health economics advisory board for GSK after this study was completed. No pharmaceutical industry funding was obtained or used for this study. None of the other authors have any conflicts of interest.
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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U2 - 10.1185/030079908X273020
DO - 10.1185/030079908X273020
M3 - Article
C2 - 18267052
AN - SCOPUS:41149134423
SN - 0300-7995
VL - 24
SP - 859
EP - 867
JO - Current Medical Research and Opinion
JF - Current Medical Research and Opinion
IS - 3
ER -