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Further doubts cast over ß-agonists

A new gold standard review is the latest to add its voice to concerns over the safety of long-

acting ß-agonists.

The updated Cochrane review found the drugs were effective at controlling symptoms but identified 'potential safety issues' with their use.

Researchers at the Cochrane Foundation are now to begin a separate review specifically to assess the safety of long-acting ß-agonists with and without

inhaled steroids.

Dr Chris Cates, co-ordinating editor of the Cochrane Airways Review Group and a GP in Bushy, Hertfordshire, said: 'The asthma-related excess deaths are about one in 12,000 – it's

not common but it can't be


'There is an issue about checking people on long-acting ß-agonists stay on inhaled steroids. The simplest way is to put them in the same inhaler.'

Dr Cates added that GPs should make asthma patients aware they would still require oral steroids if they had exacerbations, even if they were on long-acting ß-agonists.

The review looked at studies totalling 42,333 patients, including the Smart trial, which reported a significant risk of

adverse events with the drugs.

But it found they had 'significant advantages' for treatment versus placebo, including fewer symptoms, less use of rescue medication and higher quality of life.

GlaxoSmithKline, the company that makes salmaterol, said there was a 'wealth of data' on their benefits for improving asthma control.

• For the latest evidence on asthma treatment, go to

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