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ß-agonists could cut efficacy of steroids

Short-acting ß-agonists may reduce efficacy of inhaled steroids, according to new research.

In a paper presented at the American Academy of Allergy, Asthma and Immunology annual meeting in San Francisco earlier this month, researchers showed that salbutamol inhibits the effect of the steroid dexamethasone.

The US study found the problem was caused by enantiomers – mirror image molecules – of salbutamol, one of which had a beneficial effect, the other an inhibitory effect.

Professor Martyn Partridge, ex-chair of the British Thoracic Society and professor of respiratory medicine at University College London, said: 'This sort of adverse interaction has been postulated before and while the research is interesting there is no real evidence that this is a significant cause of worsening asthma at a clinical level.

'What is important is for those with asthma to have well-controlled disease so that use of short- acting ß-agonists is rarely needed.'

Dr Dermot Ryan, a GP in Loughborough, Leicestershire, said the finding was interesting because of the increasing awareness of the problems associated with the ratio of molecules within drugs.

'We need to see whether it has clinical significance through trials. But from the point of view of clinical practice there's no need to change anything.'

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