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For:	Mayor S. WHO plans to halve child asthma deaths. BMJ 1999;318:8. [PMID: 9872867 DOI: 10.1136/bmj.318.7175.8b] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]

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1	Decrease in asthma mortality rate in Israel from 1991-1995: is it related to increased use of inhaled corticosteroids? J Allergy Clin Immunol 2000;105:71-4. [PMID: 10629455 DOI: 10.1016/s0091-6749(00)90180-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Abstract BACKGROUND Asthma mortality rates (AMRs) during the last several decades increased in many countries with developed medical services, including Israel. The reasons for this trend were never established. Recent data suggested that this trend is changing. OBJECTIVES We sought to compare the AMR in Israel during 1991-1995 with that of the previous decade and to investigate a possible correlation between mortality rates and use of inhaled corticosteroids (ICSs) and beta(2)-agonists. METHODS Statistical data on the AMR in Israel during 1981-1995 were extracted. Data were analyzed for 5- and 10-year periods (1981-1990) and compared with a 5-year period (1991-1995). Data on ICS and beta(2)-agonist sales were extracted from the marketing companies' official reports. RESULTS The mean AMR per 100,000 population per year during 1981-1990 in the 5- to 34-year-old group was 0.393 +/- 0.055 and decreased to 0.202 +/- 0. 046 during the 1991-1995 period (P =.03). There was no significant difference between changes in mean AMR in the 35- to 64-year-old or in the 5- to 64-year-old group during the same periods (4.568 vs 4. 063 and 2.480 vs 2.133). The mean ICS unit sales rates (per 100,000 population per year) between 1982-1990 and 1991-1995 were 21.70 and 190.45, respectively (P <.05). The correlation between ICS sales and AMR was -0.631 (P =.016). Sales of beta(2)-agonists did not change significantly during the study period. CONCLUSIONS We identified a trend of decreased AMRs in Israel during 1991-1995. The decline in AMRs paralleled the increase in ICS sales, whereas the sales of inhaled beta(2)-agonists did not change significantly. One may speculate that the decrease in AMR may be the result of better anti-inflammatory treatment, as reflected by the increased use of ICSs. The feasibility of reducing AMRs in a country such as Israel, with low AMRs to start with, by improving medical treatment is encouraging. Collapse Key Words Collapse MESH Headings Administration, Inhalation Adolescent Adrenal Cortex Hormones/administration & dosage Adrenal Cortex Hormones/therapeutic use Adult Age Distribution Asthma/drug therapy Asthma/mortality Child Child, Preschool Drug Utilization Humans Israel Middle Aged Collapse Grants Collapse Affiliation(s) Collapse

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Cited by Other Article(s)

Decrease in asthma mortality rate in Israel from 1991-1995: is it related to increased use of inhaled corticosteroids? J Allergy Clin Immunol 2000;105:71-4. [PMID: 10629455 DOI: 10.1016/s0091-6749(00)90180-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]

Abstract

BACKGROUND

Asthma mortality rates (AMRs) during the last several decades increased in many countries with developed medical services, including Israel. The reasons for this trend were never established. Recent data suggested that this trend is changing.

OBJECTIVES

We sought to compare the AMR in Israel during 1991-1995 with that of the previous decade and to investigate a possible correlation between mortality rates and use of inhaled corticosteroids (ICSs) and beta(2)-agonists.

METHODS

Statistical data on the AMR in Israel during 1981-1995 were extracted. Data were analyzed for 5- and 10-year periods (1981-1990) and compared with a 5-year period (1991-1995). Data on ICS and beta(2)-agonist sales were extracted from the marketing companies' official reports.

RESULTS

The mean AMR per 100,000 population per year during 1981-1990 in the 5- to 34-year-old group was 0.393 +/- 0.055 and decreased to 0.202 +/- 0. 046 during the 1991-1995 period (P =.03). There was no significant difference between changes in mean AMR in the 35- to 64-year-old or in the 5- to 64-year-old group during the same periods (4.568 vs 4. 063 and 2.480 vs 2.133). The mean ICS unit sales rates (per 100,000 population per year) between 1982-1990 and 1991-1995 were 21.70 and 190.45, respectively (P <.05). The correlation between ICS sales and AMR was -0.631 (P =.016). Sales of beta(2)-agonists did not change significantly during the study period.

CONCLUSIONS

We identified a trend of decreased AMRs in Israel during 1991-1995. The decline in AMRs paralleled the increase in ICS sales, whereas the sales of inhaled beta(2)-agonists did not change significantly. One may speculate that the decrease in AMR may be the result of better anti-inflammatory treatment, as reflected by the increased use of ICSs. The feasibility of reducing AMRs in a country such as Israel, with low AMRs to start with, by improving medical treatment is encouraging.

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