Study questions value of certain asthma drugs

Authors question whether long-acting beta agonists should remain on the market, but many experts maintain that the drug still has a role in controlling asthma.

By Victoria Stagg Elliott, AMNews staff. July 24/31, 2006.

A meta-analysis published in the Annals of Internal Medicine last month has re-opened the controversy over long-acting beta agonists in the treatment of asthma.

Clearly, there are two sides to the issue.

According to the authors' conclusions, these drugs increased the risk of severe exacerbations of the disease. They asserted that regulatory agencies should reconsider whether they should remain on the market.

Many experts, however, question the study's methodology and fear its repercussions. Specifically, concerns stemmed from the notion that, since this study was widely reported in the consumer press, patients might react by stopping a treatment that might be helping them.

"Some patients take themselves off it, and they lose some control of their asthma. ... We need to talk about it first," said Sheldon L. Spector, MD, a specialist in allergy, asthma and immunology and a clinical professor of medicine at the University of California, Los Angeles. He also conducts research supported by GlaxoSmithKline into how reaction to these drugs differs on the basis of an individual's genetics.

The authors reviewed trials that compared this drug to placebo and lasted at least three months. All patients were allowed to use short-acting beta agonists as needed, and slightly more than half also were using inhaled corticosteroids. The authors found that the long-acting beta agonists were responsible for one death per one thousand patient-years of use and the majority of asthma deaths annually.