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ASTHMA MORTALITY RISK FROM BETA-AGONISTS IS EXAGGERATED.

Last year, a study reporting increased mortality in patients taking beta-agonists for asthma caused considerable alarm, even though prior studies had yielded contradictory results (see Journal Watch accession number 920225001). This meta-analysis of data pooled from six studies concluded that the association between beta-agonists and mortality is weak.

The analysis included 364 asthma patients who died (cases) and 1388 asthma patients who did not (controls). The overall odds ratio for death associated with beta-agonist use was 1.3. This association was significant when beta- agonists were administered with a nebulizer (OR, 2.5), but not when the drugs were taken orally or by metered-dose inhaler. Adults were more likely than adolescents to show an association between beta-agonist use and death.

Comment: Since beta-agonists are given by nebulizer only to the sickest patients, it seems likely that the increased risk reflects the severity of the underlying illness. These findings suggest that the alarm generated by last year's study may have been inappropriate.

— THL

Published in Journal Watch General Medicine October 29, 1993

Citation(s):

Mullen M et al. The association between beta-agonist use and death from asthma: a meta-analytic integration of case-control studies. JAMA 1993 Oct 20 270 1842-1845.

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