At the Allergy and Asthma Center we’ve experienced an increase in patients who are concerned about their asthma medications, both with regard to safety and efficacy. We are glad to see people getting more involved in their health care decisions!
The increase in questions about safety of asthma medications typically surrounds two classes of medicines: inhaled corticosteroids (ICS’s) and long-acting beta agonists (LABA’s), which are often used in fixed combinations such as Symbicort, Advair, or Dulera. THESE MEDICATIONS ARE NOT THE ANSWER FOR EVERY ASTHMATIC. Recent FDA scrutiny of prescribing patterns for fixed ICS/LABA medications has resulted in label changes, news reports highlighting safety concerns, and changes in the way the US pharmaceutical industry is approaching future research on this class of asthma treatment agents.
Although I can’t address each person’s individual asthma scenario adequately on the blog, I will say that any concerned individual should feel confident in bringing this topic up with their physician. We are interested in learning about each individual’s style, philosophy, and goals of asthma care. Asthma is a heterogenous disease, and a one-size-fits-all approach is misguided. Some patients who had success with ICS/LABA medicines in the past now prefer to try other alternatives. In most cases, this is reasonable and we provide those alternatives. When an ICS/LABA is likely the best option in a particular sitiuation, we make this recommendation and respect the patient’s style if they choose an alternative pathway.
I suggest that asthma patients read all they can about their treatment options then discuss those options (and their sources of information) with their physician prior to making a long-term decision. In the information age, we are lucky to have instant access to most data on asthma. However, it is in our best interest to find reliable and evidence-based recommendations rather than anecdotes.
Kevin Parks MD