There is now a large body of evidence documenting the role of bronchodilators on asthma exacerbations. Countless studies going back to the 1970s have highlighted the danger in over-using asthma medication. The drug Fenoterol was linked to 600 deaths before New Zealand researchers called for its withdrawal1.
Professor Julian Crane from the Wellington School of Medicine is quoted in the New Zealand Medical Journal back in 2006 as saying ‘It is unfortunate that we still do not know how some short-acting beta agonists such as isoprenaline and Fenoterol or the long-acting beta agonists (LABAs) increase the risk of death in severe asthma, but in the case of LABAs it appears to happen without excessive use.’
Long-acting beta agonists sold as Serevent and Oxis or in combination with inhaled corticosteroids as Symbicort and Seretide deliver considerably higher doses of the bronchodilator drugs so pose a higher risk of asthma exacerbations and in some cases death.
A 2006 study by Cornell and Stanford university researchers linked common asthma inhalers to up to 80 percent of asthma-related deaths2.
In December 2008, a panel of federal drug experts in the US voted that the drugs Serevent and Foradil (Oxis) should be banned from use in the treatment of asthma, noting that too many doctors used these drugs inappropriately and that asthmatic patients were often fooled by their own symptoms and used them incorrectly. The reason for the ban is that such incorrect use can result in death3.
The FDA has since revised guidelines on the use of LABAs (February, 2010) based on FDA analyses of studies showing an increased risk of severe exacerbation of asthma symptoms, leading to hospitalisations in pediatric and adult patients as well as death in some patients using LABAs for the treatment of asthma4.
The problem appears to be that dependency on asthma medication is still regarded as the norm, and there is little encouragement for people with asthma to try alternative methods to control their breathing. This despite the growing body of research demonstrating the efficacy of breathing retraining programmes such as Buteyko in asthma management (see clinical trials).
More research is required before Buteyko or other breathing retraining approaches are incorporated. However, this research needs to happen sooner rather than later if we are to curb the mortality and morbidity resulting from beta agonist use.
Note: Buteyko Breathing Clinic practitioners encourage the responsible use of asthma medication. Our clients are instructed to use their preventer medications as prescribed and their reliever medications as required. Reduction in preventer medication is always discussed with the patient’s GP.
See also: Beta Agonists and Asthma »
1 Neil Pearce Adverse Reactions: The Fenoterol Story Auckland University Press
2 Cornell University Chronicle 9th June 2006 http://www.news.cornell.edu/stories/June06/AsthmaDeaths.kr.html
3 F.D.A. Panel Votes to Ban Asthma Drugs New York Times 11 Dec 2008 http://www.nytimes.com/2008/12/12/health/policy/12fda.html?_r=2&partner=rss&emc=rss
4 Long-Acting Beta-Agonists (LABAs): New Safe Use Requirements http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm201003.htm
