Long-Acting Inhaled β-Agonists and Mortality

Earlier in 2006, findings highlighted increased risk for asthma-related deaths; more recently, experts have suggested the risks were due to use of these medications without inhaled steroids.

Results of a large randomized trial published in early 2006 led to an FDA black-box warning that long-acting inhaled β-agonists (LABAs) could increase the chance of severe asthma and death and should not be used as first-line therapy. In the SMART trial, which involved 26,355 adolescents and adults with asthma, more subjects randomized to salmeterol than to placebo experienced respiratory death or mechanical ventilation (50 vs. 36 events) by 28 weeks, but the difference did not reach statistical significance (Journal Watch Feb 17 2006).

Later in 2006, researchers published a meta-analysis of 19 randomized, placebo-controlled trials (including SMART) that involved 33,826 children and adults (Journal Watch Jul 18 2006). LABAs were significantl…

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Richard Saitz, MD, MPH, FACP, FASAM

Long-Acting Inhaled β-Agonists and Mortality

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