Long-term LABA monotherapy may increase asthma patients’ hospitalization risk
MedWire News: Long-term monotherapy with the long-acting beta-2 agonist (LABA) salmeterol is associated with an increased risk for hospitalization in patients with asthma, whereas its long term use in combination with an inhaled corticosteroid is not, results from a US study suggest.
Writing in the Annals of Allergy, Asthma, and Immunology, Carlos Camargo (Harvard Medical School, Boston, Massachusetts) and team explain: “The safety of inhaled LABAs in the treatment of chronic asthma remains controversial and has not been evaluated in emergency department (ED) patients with acute asthma.”
To address this, the researchers studied data on 2236 patients, aged 12–54 years, who attended 115 EDs suffering from asthma attacks.
Of these, 1221 (55%) patients were receiving no ICS or salmeterol (group A), 48 (2%) were receiving salmeterol monotherapy (group B), 787 (35%) were receiving ICS monotherapy (group C), and 180 (8%) were receiving combined ICS/salmeterol treatment.
In total, 489 (22%) patients required hospitalization after examination in the ED.
After accounting for factors such as smoking, age, gender, and previous hospitalizations, the researchers found that patients in group B were 2.2 times more likely to be hospitalized than those in group A (reference group).
In contrast, patients in groups C and D were no more likely to be hospitalized than those in group A, at respective odds ratios of 1.1 and 1.2.
Camargo and team conclude: “Among ED patients with acute asthma, those undergoing salmeterol monotherapy had an increased risk of hospitalization; however, this risk was not seen among patients undergoing combination ICS-salmeterol therapy.”
They add: “Our findings provide data from a unique ED population on clinical response to acute asthma treatment among patients undergoing long-term LABA therapy.”
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By Mark Cowen