Source: Annual Congress 2002 - New aspects of asthma epidemiology
Disease area: Airway diseases

Abstract

Inhaled corticosteroids are effective at preventing asthma morbidity and mortality. Most studies, however have focussed on short-term effects, raising uncertainty about their effectiveness in the long term.
We used the Saskatchewan Health databases to form two population-based cohorts of asthma patients aged 5 to 44, between 1975 and 1991. The first cohort included all subjects as of the start of asthma treatment, while the second included subjects hospitalised for asthma as of the date of discharge. Subjects were followed up from one year after cohort entry until 1997, 54 years of age, or death. The outcome was the first asthma hospitalisation to occur during follow-up. Nested-case-control designs were used by which all cases were matched on calendar time and several markers of asthma severity to all available controls within the cohort.
The entire cohort included 30,569 asthmatics, of which the 3,894 were hospitalised for asthma and 1,886 readmitted to hospital for asthma after a year of follow-up. Regular use of inhaled corticosteroids was associated with reductions of 31% in the rate of asthma hospitalisation (95 percent confidence interval:17% to 43%) and 39% in the readmission rate (95 percent confidence interval:25% to 50%), relative to non use or irregular use. The rate reduction was sustained after 5 years of follow-up. Consequently, we can estimate that regular use of inhaled corticosteroids can systematically prevent between 5 hospitalisations and 27 readmissions per 1000 asthma patients per year.
We conclude that regular use of low-dose inhaled corticosteroids prevents a large proportion of asthma hospitalisations, both early and later on in the disease course.

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Citations should be made in the following way:
S. Suissa, P. Ernst, A. Kezouh (Montreal, Canada). Regular use of inhaled corticosteroids and the long-term prevention of hospitalisation for asthma. Eur Respir J 2002; 20: Suppl. 38, 166

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