How Would You Like an LABA Substitute?
I came across an article on the Denver Post website this morning you should read. In it, you’ll learn about tiotropium, a COPD medication that could serve as an alternative treatment for people who need long-acting beta-agonists like Serevent.
LABAs, you’ll recall, work just fine for most asthmatics but now carry a black-box warning because of their connection to severe and fatal asthma attacks for a small percentage of patients. No one really knows why some people can’t tolerate LABAs while most can, so another option would be a good thing.
This particular article, though, contains some puzzling terminology that a casual reader likely wouldn’t even notice but could easily confuse people new to asthma. Namely, I didn’t find the descriptor “long-acting” one time – not once – in the entire story, save for a quote 2/3 of the way down from National Jewish’s Richard Martin, lead investigator of the Denver-area portion of the study.
Plus, the story doesn’t even name the specific LABAs in question until the seventh paragraph:
Beta agonists, such as Serevent and Foradil, are commonly used in combination with inhaled corticosteroids. Medicines such as Advair and Symbicort contain the combination.
Is it just me, or is that sentence really unclear? Not only does it imply meds like Serevent and Foradil are the only type of beta-agonists available, but the entire article also makes no mention of any other kind.
Just look at the lead:
Asthma sufferers worried by research that beta-agonist drugs used to control their condition might pose a risk of death could have an alternative, according to a study published Sunday in the New England Journal of Medicine. [emphasis mine]
If I’d read that sentence when I first started learning about my daughter’s asthma, my brain would have defaulted to, IS THE BREATHING PROBLEM NOT ENOUGH? YOU’RE TELLING ME THE MEDS TO TREAT IT ARE RISKY, TOO?
Asthma treatment options include two types of beta-agonists. Only the long-acting ones are at issue here. The short-acting beta-agonist salbutamol/albuterol, like in the very common ProAir HFA, is the everyday quick-relief inhaler most people use and doesn’t have a black-box warning. There’s a big difference.