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  Authority of Polish Society of Allergology

vol 13. no 4. December 2008  

 Review articles
Should we be afraid of application of long-acting β2-agonists?
Mirosław Szmidt

The administration of short-acting beta-2 agonists (SABA) in inhalers releasing higher doses of drug was the cause of asthma death epidemics in Great Britain in the fifties and in New Zealand in the seventies of the last century. Pharmacological studies show that beta-2 adrenergic agonists may exert adverse effects which can contribute to increased asthma mortality. The results of prospective study SMART and meta-analyses also suggest that the administration of long-acting beta 2 agonists (LABA) may be associated with increased number of asthma deaths in asthmatics. FDA issued “Black box warnings” against the application of LABA (salmeterol, formoterol) in monotherapy. However, the cause of this increased mortality may not be due to the adverse effects of LABA but rather to a special psychosocial situation. In exacerbation of asthma some patients rely too much on LABA and seek medical help too late. The recently published meta-analyses concerning the administration of LABA and inhaled glucocorticosteroids applied simultaneously did not reveal increased mortality in asthma and COPD. It was also shown that there are no differences in the response to LABA between groups with polymorphism Arg16Arg and Gly 16Gly during therapy with LABA and inhaled glucocorticosteroids. More common use of LABA and inhaled glucocorticosteroids in one inhaler (Symbicort – Astra, Seretide – Glaxo) may prevent patients with asthma from taking LABA in monotherapy.

keywords: astma, LABA, śmiertelność, asthma, LABA, mortality

pages: from 197 to 201

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