Abstract
Dr. Devoy and colleagues have performed a valuable service by reviewing the clinical studies of inhaled long-acting β2-agonists in asthma (CHEST 1995; 107:1116-24). Of the studies reviewed, only one was large enough to begin to examine the effect of these drugs on the prevalence of asthma death. 1 Castle W. Fuller R. Hall J. et al. Serevent nationwide surveillance study: comparison of salmeterol with salbutamol in asthmatic patients who require regular bronchodialator treatment. BMJ. 1993; 306: 1034-1037 Crossref PubMed Scopus (425) Google Scholar In this study, Castle and colleagues 1 Castle W. Fuller R. Hall J. et al. Serevent nationwide surveillance study: comparison of salmeterol with salbutamol in asthmatic patients who require regular bronchodialator treatment. BMJ. 1993; 306: 1034-1037 Crossref PubMed Scopus (425) Google Scholar found that regular use of salmeterol resulted in an asthma death rate three times that associated with regular use of albuterol. They indicated that there was an 89.5% probability that this was a result of the difference in therapy and a 10.5% probability that this occurred by chance alone.1, footnote to Tabe 3 Thus, it is not proven that salmeterol does not adversely affect asthma mortality, although Devoy and colleagues make this assertion (Table 1).
Published Version
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