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    Asthma Drug Combo Could Be Dangerous

    Long-Acting Beta Agonist and Inhaled Steroid Sometimes Have Negative Side Effects

    Side Effects of Drug Combo continued...

    When the long-acting asthma medication was replaced with another asthma treatment, the boys' asthma control improved, as did their response to the medications used to treat an acute attack -- or quick relief therapy.

    Weinberger says most patients whose asthma cannot be controlled with a low-dose inhaled steroid do benefit from adding a long-acting bronchodilator to their daily maintenance treatment.

    But he adds that it is increasingly clear that there is a small subgroup of patients for whom the combination treatment has a negative, rather than positive, effect.

    "We do not want to unduly alarm people but instead help spread the word that patients should talk to their physicians if they are using Advair, or another inhaled asthma medication that contains salmeterol, and feel that it worsens symptoms instead of making them better," he says.

    Follow Patients Closely

    In both cases highlighted by Weinberger and Abu-Hasan, treatment with the long-acting drug appeared to render quick-relief therapy ineffective. But GlaxoSmithKline spokeswoman Mary Anne Rhyne tells WebMD that the clinical evidence shows that the vast majority of patients on a long-acting beta agonist remain responsive to treatment with albuterol.

    "There will always be some patients who are not responsive to any medicines, but it is very difficult to draw conclusion from the brief case reports outlined in Dr. Weinberger's letter," she says.

    Rhyne agrees that patients on long-acting bronchodilators should be monitored very closely by their doctors, as should patients on any therapy for moderate to severe asthma.

    "Advair has been proven safe and effective for millions of patients," she says. "But it is not right for everyone. Asthma can be a deadly disease and severe problems can come on quite quickly, so it is important that patients tell their physicians about symptoms and their responses to medication."

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