-Caveat Lector-

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My husband was given Serevent in 1999, after he visited the local urgent care center 
complaining of shortness of breath. I thought it unusual because the first-line 
treatment for asthma is albuterol, with Serevent only given to boost the albuterol. 
Albuterol is a fast-acting bronchodilator, Serevent is a slow-acting b-d, supposed to 
last 8 hours. At one time, I took both (along with oral and inhaled steroids), then I 
found out what was triggering the asthma (yellow #5 food coloring) & eliminated it 
from my diet & now I don't take anything. At the time my husband was given the 
Serevent, I spoke up, and my husband asked me "Who's the doctor here?" so I shut up. 3 
weeks later, he took the Serevent for another bout of shortness of breath, and within 
2 hours, had a heart attack. Hooray for Big Pharma!

[EMAIL PROTECTED]


Asthma Drug Health Risks Are Suspected, Company Says

January 24, 2003
By REED ABELSON






GlaxoSmithKline said yesterday that Serevent, one of its
popular asthma drugs, might pose a risk of death and
serious asthma-related illness in some patients.

The company said it was halting the study it had been
conducting since 1996 to evaluate Serevent's safety because
the study was unlikely to be conclusive. GlaxoSmithKline
said it would work with regulators to design further
studies to address concerns about Serevent's safety.

While the results of the study were not statistically
significant, they suggested that people who use Serevent,
particularly African-Americans, might be at greater risk
for life-threatening attacks or deaths associated with
their asthma. People who use Serevent without also taking
inhaled steroids to control their asthma may also be at
increased risk.

The Food and Drug Administration, which issued a statement
yesterday about the study, emphasized that the benefits of
Serevent for people with asthma continued to outweigh the
risks based on current information. The agency said it
would meet with GlaxoSmithKline to discuss the findings and
was interested in further evaluating whether certain
patients might be at greater risk for what it described as
rare but potentially serious adverse effects from their use
of the drug.

"Patients who require significant treatment should not be
afraid of using Serevent," said Dr. Lanny Rosenwasser, a
professor at the National Jewish Medical and Research
Center and the incoming president of the American Academy
of Allergy Asthma and Immunology.

Previous studies had indicated that Serevent and similar
drugs were not successful in controlling asthma alone, he
said.

"You need another controller medicine," Dr. Rosenwasser
said.

GlaxoSmithKline makes another asthma drug, Advair, which
has the active drug in Serevent. But Advair combines
Serevent with a type of inhaled steroid that is recommended
by doctors to control the inflammation associated with
asthma.

While Serevent received regulatory approval in 1994, the
food and drug agency said it had received some reports of
asthma-related deaths associated with the drug, which
prompted the study. Studies had also raised concerns about
a class of drug known as beta agonists, which includes
Serevent. About 26,000 patients participated in the study,
which had been intended to enroll 60,000.

Although the preliminary analysis of the study suggested
additional risks, they were not statistically significant
because of the small number of deaths and other serious
effects, said Dr. Kate Knobil, a research physician at
GlaxoSmithKline. The company would soon make public the
number of these cases, she said, but was still compiling
the information.

The increased risk appears to be driven by the lack of
inhaled steroid use, Dr. Knobil said.

Despite medical recommendations that patients use inhaled
steroids or some other medication, many patients in the
study were not being treated with additional medicine. Less
than half, or 47 percent, of the patients used inhaled
steroids. Whether or not a patient was using an inhaled
steroid was determined by that patient's doctor, not the
company.

African-American patients were less likely to be using
inhaled steroids and were more likely to have a more severe
case of the disease, which could partly explain why they
were at greater risk for death or other serious problems.
But genetics might also play a role, Dr. Rosenwasser said.

In addition to asking for further studies, the drug agency
might require GlaxoSmithKline to change how it labels the
drug or otherwise alert doctors to its risks.

Analysts played down the significance of the study while
acknowledging that it gives GlaxoSmithKline's competitors
some advantage in promoting their own drugs to treat
asthma.

"It's a little marketing nudge here and there," said Todd
Lebor, an analyst with Morningstar Inc. in Chicago.

While the asthma franchise, which includes Advair, is
important, Mr. Lebor said, it is a small part of
GlaxoSmithKline's nearly $30 billion in revenue. "They
don't have a blockbuster portfolio," he said.

For the nine months ended Sept. 30, the company sold $574
million in Serevent, with $327 million coming in the United
States. Advair sales reached $1.7 billion, of which $925
million were in the United States.

http://www.nytimes.com/2003/01/24/health/24ASTH.html?ex=1044415472&ei=1&en=25aea4c56bf6984f



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