Rise and fall of asthma-related mortality in Italy and sales of beta 2-agonists, 1980-1994

We performed this study with the aims of describing the trend of asthma-rel ated mortality in Italy between 1980 and 1994, and to evaluate the relation ship between sale estimates of beta (2)-agonists drugs and mortality from a sthma. For asthma mortality we used data provided by National Institute of Statistics, for sale estimates of beta (2)-agonists we used data provided b y IMS HEALTH. We calculated the gender specific age-standardized incidence rates of asthma-related deaths for all ages and for age classes. We found t hat estimates for asthma-related mortality steadily increased between 1980 and 1987 in both sexes, and thereafter decreased. In people, aged between 3 4 and 64 and over 64, death rates in males were significantly higher than i n females while the rates in those aged less than 34, were mostly similar i n both gender. The overall exposure to beta (2)-agonists (alone and in comb ination) increased from 1980 to 1990, remained stable between 1990 and 1993 , and increased steeply in 1994. We conclude that asthma-related death rate s have declined since the mid-1980's. This decline has been more pronounced in males and in the older ages, while the rates in younger patients of bot h genders have remained nearly unchanged. Our data do not substantiate the hypothesis of an increased risk of asthma-related mortality associated to t he use of inhaled beta (2)-agonists in general nor fenoterol or salbutamol in particular.