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Study reveals a lower prevalence of a rare vasculitis syndrome among asthma drug users than previously reported

Only a small minority of people with asthma suffer from Churg-Strauss syndrome (CSS), a rare systemic vasculitis, which involves inflammation of the blood vessels in the lungs, skin, nerves, abdomen, and other organs. Some studies have linked the development of CSS with the use of relatively new drugs such as Singulair™ (montelukast). These drugs block the action of leukotrienes, which regulate allergic and inflammatory reactions. Leukotrienes are released during the inflammation process that occurs in asthma. A new study shows a lower prevalence of CSS among asthma drug users, including users of leukotriene modifiers, than previously reported.

The study, supported in part by the Agency for Healthcare Research and Quality (HS10391), estimated the incidence of CSS among adults with asthma who had been dispensed three or more asthma drugs at three managed care organizations during any consecutive 12-month period between January 1, 1995 and June 30, 2000. Asthma drugs ranged from leukotriene modifiers and inhaled corticosteroids to cromolyn-like medications, beta agonists, and theophylline.

From the medical records of 184,667 asthma drug users, the researchers identified 21 cases of CSS, for an overall incidence of 34.6 per million person-years. CSS rates did not differ by sex or age group.

The incidence rates for 1995, 1996, 1997, 1998, 1999, and the first 6 months of 2000 were 0, 22, 52, 75, 14, and 14 per million person-years respectively. Most of these estimates were below previous CSS estimates of 60 per million person-years among people with asthma using leukotriene modifiers and other asthma drugs, but greater than that seen in the general population.

See "Incidence of Churg-Strauss syndrome in asthma drug users: A population-based perspective," by Leslie R. Harrold, M.D., M.P.H., Susan E. Andrade, Sc.D., Alan S. Go, M.D., and others, in the June 2005 Journal of Rheumatology 32(6), pp. 1076-1080.

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