Steroids have a bad reputation with the public, stemming largely from their negative association with professional athletes.
But a panel that advises the Food and Drug Administration suggests that steroids are the difference between asthma drugs that are safe to take and asthma drugs that are dangerous, according to Reuters.
The panel concluded recently that Advair, a widely prescribed drug, and Symbicort are safe for use in the treatment of asthma. The use of two other drugs, Serevent and Foradil, should be discontinued, according to the panel.
All four drugs include long-acting beta agonists (LABA), but Symbicort and Advair add a steroid, which the panel felt made the drugs safer for public consumption.
The absence of a steroid worked against Serevent and Foradil, a consumer advocate told Reuters. The New York Times reports that “too many doctors used (the drugs) inappropriately” and “patients were often fooled by their own symptoms and used them incorrectly.”
“It looks like use of LABAs alone is more dangerous,” Sidney Wolfe, director of Public Citizen’s Health Research Group, said.
There is no cure for asthma, but its symptoms, like wheezing, shortness of breath, coughing and tightness of the chest, can be controlled.
Asthmatic episodes frequently are brought on by environmental factors, like tobacco smoke, perfume, cold or warm air and common allergens. An episode also can be caused by physical exertion or stress.
In an asthmatic attack, airways spasm and swell in the lungs. Steroids and beta agonists are the major treatments.
“Serevent and Foradil are also approved to treat chronic obstructive pulmonary disorders like emphysema,” reports the Times. “So even if the agency follows the panel’s advice, the drugs will remain on the market.”
Two classes of drugs are used to treat asthma, according to Scientific American – relievers and controllers.
Relievers act quickly to ease airflow during an asthma attack.
“Controllers, on the other hand, work gradually and must be taken on a regular basis to control the root of the disease,” reports Scientific American. “LABAs are controllers, which are effective for as long as 12 hours. According to National Institutes of Health (NIH) guidelines, LABAs should only be taken with inhaled corticosteroids (ICS), which help to reduce inflammation and mucus buildup in the airways.”
Foradil was approved for use seven years ago, and Serevent was approved in 1994, “but two years ago the FDA ordered the companies to put black box warnings on them alerting consumers to their potential dangers,” writes Scientific American.
Approximately 300 million people around the world suffer from asthma, reports Scientific American, and about 20 million of them are from the United States.