RISK OF EMERGENCY CARE, HOSPITALIZATION, AND ICU STAYS FOR ACUTE ASTHMA AMONG RECIPIENTS OF SALMETEROL

We used automated health insurance claims records of a New England ins urer to assess the relation between salmeterol and severe nonfatal ast hma. We identified 61,712 members who received a beta-agonist from Jan uary 1, 1993 to August 31, 1995, including 2,708 recipients of salmete rol. Compared with recipients of other beta-agonists, future salmetero l recipients had higher rates of asthma hospitalization and dispensing s of asthma medications during the year before they received salmetero l. We selected as a comparison group 3,825 recipients of sustained-rel ease theophylline. We defined a baseline period as the year before the start of the follow-up period, and we characterized patients accordin g to age, sex, calendar period, presence of baseline hospitalizations for asthma, presence of chronic obstructive pulmonary disease (COPD), and baseline dispensings of asthma medications. After adjusting for ba seline factors, incidence rates of severe asthma in the salmeterol gro up were not elevated for emergency care (rate ratio estimate [RR] = 0. 69, 95% confidence intervals [CI] = 0.42, 1.11), hospitalization (RR = 1.09, 95% CI = 0.60, 1.98), or intensive care unit (ICU) stays (RR = 0.81, 95% CI = 0.25, 2.62). We conclude that salmeterol was prescribed preferentially to high-risk patients and, after adjusting for baselin e risk, salmeterol recipients did not have a greater risk than theophy lline recipients of severe nonfatal asthma.