New data reveal that the asthma drug salmeterol may lead to an increased risk of respiratory- and asthma-related deaths in African American patients. In the Salmeterol Multicenter Asthma Research Trial (SMART), researchers from GlaxoSmithKline, Research Triangle Park, NC, National Jewish Medical and Research Center, Denver, CO, Brigham and Women's Hospital, Boston, MA, and Wake Forest University School of Medicine, Winston Salem, NC, compared respiratory-related and asthma-related outcomes in 26,355 subjects (71 percent Caucasian and 18 percent African American) receiving usual asthma pharmacotherapy alone or usual asthma pharmacotherapy plus salmeterol for a duration of 28 weeks. Results showed that there were small, but significant increases in respiratory- and asthma-related deaths and in combined asthma-related deaths or life-threatening experiences in subjects receiving salmeterol vs placebo. A subgroup analyses showed the risk for these adverse events may be higher in African American patients compared with Caucasian patients. The study was terminated due to the findings among African American patients and difficulties in enrollment. The study appears in the January issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.
MAJORITY OF ADULT INPATIENTS WITH ASTHMA ARE FEMALE
A new study shows that patients with asthma who are hospitalized have distinct gender and age differences. Researchers from Kaiser-Permanente Medical Care Program, San Diego, CA, reviewed the demographics and medical histories of 606 pediatric patients and 680 adult patients admitted for acute asthma during 1999-2000. Overall, 40 percent of pediatric patients were female, compared with 68 percent in the adult group. Among children, girls did not differ from boys according to asthma history, pulmonary index scores, or hospital length of stay. Among adults, women were more likely to have a primary care provider than men but did not differ according to asthma history or recent medication use. Women had a higher mean peak expiratory flow compared with men and a higher median initial oxygen saturation but did not differ in hospital length of stay. Researchers conclude that the results in children are probably explained by increased disease prevalence in pediatric males. The study appears in the January issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.
FISH OIL BENEFITS PATIENTS WITH EXERCISE-INDUCED AIRWAY CONSTRICTION
Fish oil may have potential benefits for patients with asthma who suffer from exercise-induced bronchoconstriction (EIB). Researchers from Indiana University, Bloomington, IN, examined the effect of fish oil supplementation on 16 patients with asthma with documented EIB. For 3 weeks, half of the patients received daily fish oil capsules, while the other half received placebo capsules. At the beginning of the study and at the end of each treatment phase, patients' preexercise and postexercise measures were assessed, including pulmonary function, induced sputum fluid phase measurements, and airway inflammation. Results showed that the fish oil diet improved pulmonary function to below the diagnostic EIB threshold, with a concurrent reduction in bronchodilator use. Patients receiving the fish oil diet also experienced reductions in induced sputum differential cell count percentage and airway inflammation. Researchers conclude that fish oil supplementation may represent a potentially beneficial nonpharmacologic intervention for asthmatic patients with EIB. The study appears in the January issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.