title: Risk of fatal and near-fatal asthma in relation to inhaled corticosteroid use.
abstract: OBJECTIVE
  To examine the relationship between patterns of use of inhaled beclomethasone dipropionate and the risk of fatal and near-fatal asthma.
  
  
  METHODS
  Nested case-control analysis of a historical cohort; a further analysis.
  
  
  METHODS
  The 12,301 residents of Saskatchewan aged 5 to 54 years who were dispensed 10 or more asthma drugs from 1978 to 1987.
  
  
  METHODS
  The 129 persons who experienced asthma death (n = 44) and near-death (n = 85) and their 655 controls matched as to age and date of entry into the cohort, with the additional matching criteria of at least one hospitalization for asthma in the prior 2 years, region of residence, and having received social assistance.
  
  
  RESULTS
  Life-threatening attacks of asthma defined as death due to asthma or the occurrence of hypercarbia, intubation, and mechanical ventilation during an acute attack of asthma.
  
  
  RESULTS
  After accounting for the risk associated with use of other medications and adjustment for markers of risk of adverse events related to asthma, subjects who had been dispensed, on average, one or more metered-dose inhalers of beclomethasone per month over a 1-year period had a significantly lower risk of fatal and near-fatal asthma (odds ratio, 0.1; 95% confidence interval, 0.02 to 0.6).
  
  
  CONCLUSIONS
  These data support recent guidelines from several countries that recommend the use of inhaled corticosteroids in moderate and severe asthma.
authors.affiliation: Department of Epidemiology, Montreal General Hospital, McGill University, Quebec, Canada.
authors.forename: P
authors.initials: P
authors.lastname: Ernst
authors.forename: W O
authors.initials: WO
authors.lastname: Spitzer
authors.forename: S
authors.initials: S
authors.lastname: Suissa
authors.forename: D
authors.initials: D
authors.lastname: Cockcroft
authors.forename: B
authors.initials: B
authors.lastname: Habbick
authors.forename: R I
authors.initials: RI
authors.lastname: Horwitz
authors.forename: J F
authors.initials: JF
authors.lastname: Boivin
authors.forename: M
authors.initials: M
authors.lastname: McNutt
authors.forename: A S
authors.initials: AS
authors.lastname: Buist
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000188:drug therapy / Q000209:etiology / Q000401:mortality*; D001507:Beclomethasone / Q000008:administration & dosage*; D016022:Case-Control Studies; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D016017:Odds Ratio; D012044:Regression Analysis; D012307:Risk Factors; D012525:Saskatchewan / Q000453:epidemiology
chemical_list: D001507:Beclomethasone