Serevent, an aerosol spray made by GlaxoSmithKline,
opens the airwaves to help asthma patients breathe more easily. Patients use
it twice a day to prevent attacks.
Due to concerns about the drug, Glaxo launched a large study to compare
the number of life-threatening experiences, such as intubations and
mechanical ventilation, and the number of asthma-related deaths in patients
taking the drug vs. the number of such occurrences in patients given a
placebo.
The study found a greater risk of problems and a greater risk of death
among black patients, and found a disparity in deaths among those who were
not using a companion drug aimed at controlling inflammation.
As a result, the company and the FDA are emphasizing existing guidelines
that say asthma patients whose disease is severe enough to require daily
medication should also be using inhaled corticosteriods, which control
inflammation.
"Someone who needs Serevent should be on something to control
inflammation too," said Dr. Robert J. Meyer, director of one of the FDA's
offices of drug evaluation.
The study was not designed to determine why certain Serevent patients
were more likely to suffer problems, but rather to see if Serevent itself
posed a threat, Meyer said.
The 28-week study included 26,000 patients. Originally designed to enroll
60,000 patients, Glaxo ended it early because of difficulty finding
participants and because it was not designed to analyze the questions raised
early in the study, company and FDA officials said.
When entering the study, 47 percent of all patients were using a
corticosteroid. Black patients were less likely to be using these drugs than
whites were, and that may explain at least part of why blacks using Serevent
were more likely to have lung problems and more likely to die than whites
were.
Officials at the company and the FDA did not know if other factors
contributed to the racial disparities. Due to socioeconomic and other
factors, blacks are more likely to face health problems. Overall, the
severity of asthma is worse among blacks than whites.
Neither Glaxo nor FDA officials would say precisely how many people in
each group had complications and how many died.
An estimated 16 million people in the United States have asthma, and
about 1.3 million use Serevent.
The FDA approved Serevent, also known as salmeterol xinafoate, to treat
asthma in 1994 and later extended its approval for treatment of chronic
obstructive pulmonary disease.
On the Net:
FDA: http:/www.fda.gov
GlaxoSmithKline: http://www.gsk.com