seravent warning??

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Ensoul100 - 03 Dec 2004 05:13 GMT

rare but fatal side effect, death

I take advair 500/50, which has seravent/salmeterol

this is in the US a warning for it, FDA hasn't recalled it yet
Dr know I take it

anybody else hear of this? know more info about it?

thanks

ensoul

When will our consciences grow so tender that we will act to prevent human
misery rather than avenge it?
~Eleanor Roosevelt

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Joy - 03 Dec 2004 06:05 GMT

RU Black? You might worry.
Joy

> rare but fatal side effect, death
>
[quoted text clipped - 12 lines]
> misery rather than avenge it?
> ~Eleanor Roosevelt

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Joy - 03 Dec 2004 06:20 GMT

You know, you might worry if you are African descent. Other than
that.............
Just use Avair instead.

Joy

> rare but fatal side effect, death
>
[quoted text clipped - 12 lines]
> misery rather than avenge it?
> ~Eleanor Roosevelt

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jackmallory@webtv.net - 04 Dec 2004 23:37 GMT

"They" claim the salmeterol is only dangerous wen NOT accompanied by a
steroid. With Advair (in England Seratide) you get both.

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00doc - 04 Dec 2004 23:55 GMT

> "They" claim the salmeterol is only dangerous wen NOT
> accompanied by a
> steroid. With Advair (in England Seratide) you get both.

That is what the statistics seems to show. Serevent has been
associated with increased deaths - but the only group that
has shown this association is black children with a baseline
of poor control and not taking inhaled steroids (which to me
suggests they are also not getting very good medical care).

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Alison Chaiken - 05 Dec 2004 03:45 GMT

> That is what the statistics seems to show. Serevent has been
> associated with increased deaths - but the only group that has shown
> this association is black children with a baseline of poor control
> and not taking inhaled steroids (which to me suggests they are also
> not getting very good medical care).

Last week I heard a seminar about the new field of pharmacogenomics.
Pharmagenomics is the study of how a patient's particular complement
of genes affect his or her reaction to a drug, be it positive or "side
effect." The speaker, Prof. Russ Altman of Stanford, reminded us that
there is more genetic variation among Africans than there is genetic
difference between Africans and all other races. In other words,
there are groups of Africans who are more distantly related to each
other than some groups of Africans are to Asians, Europeans or other
indigenous peoples. This is because all Asians, Europeans, etc. are
descended from a single group of ancestors who left Africa in
prehistoric times.

The result of this large genetic variation among Africans compared to
other races is that most outlier drug effects, both adverse and
positive are among Africans. Prof. Altman showed a graph that had an
indicator of positive drug effects on one axis and negative drug
effects on the other for a particular chemotherapy drug. People who
had a very good experience with the drug were in one corner of the
graph and people who had a terrible experience were in the opposite
corner. Both outlier groups were Africans racially!

What all this has to do with asthma: the upshot is that it's hardly
surprising that black children have an unusual adverse effect to
serevent. Someday soon there may be an inexpensive genetic test
available that will say that some people shouldn't take serevent and
would benefit more from another drug.

Interestingly asthma is one of the primary diseases that
pharmacogenomists study. Visit http://www.pharmgkb.org/ and type
"asthma" into the "Search PharmGKB" box and notice the 196 results.
http://www.pharmgkb.org/views/index.jsp?objId=PA443450&objCls=Disease
is the main asthma page. Singulair is found in the database although
it looks like the gene(s) responsible for its variable effectiveness
is not yet identified.

Disclaimer: I'm not actually a pharmacogenomist so I apologize to
Prof. Altman if I've misquoted him.

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Alison Chaiken "From:" address above is valid.
(650) 236-2231 [daytime] http://www.wsrcc.com/alison/
Nil tibi scribo quidem, quod non prius ipse probassem. -- Heraclius

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00doc - 05 Dec 2004 04:34 GMT

> What all this has to do with asthma: the upshot is that
> it's hardly
[quoted text clipped - 5 lines]
> serevent and
> would benefit more from another drug.

There probably will be tests like that for a lot of other
drugs and even for picking the ideal regimen for asthmatics.
However, in this case the real answer is just to add an
inhaled steroid for control before just putting them on a
long acting dilator - as I think most docs would do anyway
(rgardless of race). So I doubt there will ever be much of a
use or market for the assays in this particular instance -
no that they won't be done to settle other questions.

Kind of like they talk about in this article:

http://www.sciencenews.org/articles/20041127/bob9.asp

One other point: I don't think we really know if the
increased deaths were from adding the Serevent (from the
drug) or from a lack of steroids (from the disease). The
discussion of different genetic predispositions still
applies - it is just not clear exactly how.

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00doc

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