Long-Acting Beta-Agonists and the Risk of Intensive Care Unit Admission in Children

Abstract

Objective. A possible association between long-acting beta-agonists (LABA) and severe asthma exacerbations including death remains controversial. We examined whether LABA in the setting of combination therapy with inhaled corticosteroids (ICS) increase the risk of near-fatal asthma in children using a case–control study design. Methods. Medical records from admissions for asthma exacerbations in children 4–18 years of age during the 2005 calendar year at Children’s Hospital of Pittsburgh of UPMC were reviewed. Cases and controls were determined by pediatric intensive care unit (PICU) and floor admission, respectively. Exposure was defined by LABA use in combination with ICS versus ICS alone. Results. Records from 85 PICU and 96 pediatric floor admissions were reviewed. LABA use in combination with ICS did not increase the risk of PICU admission (odds ratio 1.07, 95% CI 0.46–2.52) compared to ICS only without LABA. After adjusting for demographics, asthma severity, history of PICU admissions, and concurrent infection, LABA/ICS use still did not increase the risk of PICU admission (adjusted odds ratio 0.84, 95% CI 0.26–2.76) compared to ICS alone. There were no deaths and five intubations within the study period. Conclusions. The combination of LABA and ICS did not appear to increase the risk of near-fatal asthma in children.

• asthma
• drug safety
• inhaled corticosteroids
• long-acting beta-agonist

Acknowledgments

Contributions from Dr. Jones were made possible by Grant Number 5UL1 RR024153-04 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research.

Declaration of Interest

None of the authors report any conflict of interest. The contents are solely the responsibility of the authors and do not necessarily represent the official view of the NCRR or the NIH.