Dangerous Asthma Drugs: Short-Term Relief, Long-Term Death

Washington, DCTake our dangerous asthma drug. Please. It will relieve your symptoms. Oh, but it could also worsen your asthma, which could kill you. But you'll die happy. Have a nice day.

Give us a break.

Are you as sick as the rest of us with the 'drugification' of America? They make drugs for everything, and more than half the time the drugs are worse than the symptoms you are suffering from. Witness the ads on TV, where it takes the announcer three times as long to rattle off the adverse affects, the dangers and the limitations of Drug XYZ, than it does to reveal the benefits.

Now, asthma is a huge concern amongst Americans, with about 15 million suffering from some form of the debilitating breathing condition. And the numbers appear to be rising. While there is no conclusive theory as to what might be causing the growth in asthma, chemicals and a host of other substances we are routinely exposed to on a daily basis, doesn't help. Nor does the changing weather patterns, which provide more hot weather and more smog days than we used to see. For people with breathing problems, just getting through the day can be hell.

Thus, there is a need for something that will, when required, open up the lungs and allow the asthma sufferer to get some life-sustaining air. But what is the benefit, were a drug to afford short-term improvement, only to foster long-term degradation of health, and escalation or worsening of the overall condition, to the point of threatening life itself?

The US Food and Drug Administration (FDA) has three asthma drugs under surveillance, and discussion is underway to determine if the trio's continuation in the market might be ill-advised.

The three are Serevent and Advair, both made by UK-based GlaxoSmithKline, and Foradil, which is made by Novartis but marketed by Schering-Plough. Long-acting beta-agonists, they are seen to relieve short-term asthma symptoms, but also contribute to bronchial inflammation, which can lead to death.

The numbers are quite significant. It has been found that asthma sufferers who take any of the three asthma drugs noted above, are 3.5 times more likely to die from their asthma, as are individuals who utilize any asthma relief medication that does not fall within the long-acting beta-agonist family. While the foregoing has been determined by experts as being statistically significant, the next number certainly drives the point home: out of the roughly 5000 deaths in the US each year attributed to asthma, 4000 of those have been linked to long-acting beta-agonists.

That's extremely significant.

Serevent and Advair were mandated to include black box warnings, the highest and most stringent warning the FDA can bestow on a product without yanking it from the market completely. And there it is, on the Glaxo web site: "Long-acting beta-adrenergic agonists, such as salmeterol, the active ingredient in SEREVENT DISKUS, may increase the risk of asthma-related death."

Foradil, meanwhile, was tagged with a warning pertaining to the risk for worsened breathing. All three are under the FDA microscope with a view to potentially remove them from the market. That may, or may not happen according to the agency's track record with regard to dangerous drugs that put the public health at risk (Trasylol comes to mind).

In fact, researchers are currently experimenting with Nadolol, a beta-blocker, for the treatment of asthma. Now, this drug has long since been pegged as inappropriate for asthma sufferers, and has the opposite affect as the long-acting beta-antagonists described above. Instead of providing immediate relief, but with long-term risk, Nadolol is being shown to exacerbate asthma symptoms in the short term, but over the long haul is believed to bring lasting improvement to a patient's breathing.

At least that's the theory, according to Dr. Richard Bond, associate professor of pharmacology at the University of Houston and one of the originators of the thesis, which he dubs 'paradoxical pharmacology.'

Much like exercise, we're talking short-term pain for long-term gain, in a situation similar to the advent of beta-blocker use for the treatment of congestive heart failure, an idea that seemed completely foreign just ten years ago.

However, while that research continues, the FDA and its expert panel must decide what to do with the 'Three Asthmateers'—Serevent, Advair and Foradil. Left unchecked, asthma can kill. But treatment with certain dangerous asthma drugs can also kill, and rob the life of someone who may have survived, albeit somewhat uncomfortably, with asthma.

Many of those who die are otherwise healthy, and young. A true tragedy. Little wonder that critics of Serevent, Advair and Foradil advocate the removal of those drugs from the market, as "these long-lasting beta-agonists kill a lot of people."

That's a statement that will reverberate through the courts of law.