Children given long acting beta 2 agonists (salmeterol or formoterol) in combination with inhaled steroids have an increased risk of worsened asthma attacks.
“In children, combination therapy did not lead to a significant reduction, but rather a trend towards an increased risk, of oral steroid-treated exacerbations and hospital admissions. These trends raised concern about the safety of combination therapy in view of modest improvement in children under the age of 12 years.” http://www.ncbi.nlm.nih.gov/pubmed/20393943
This publication reviewed 48 studies that in total involved 1155 children and 14,000 adults. In adults they found a very slight benefit of combination drug use – very slight. Inadequately controlled asthmatics were compared when given either a dose of 1000 mcg per day of Beclomethasone or a lower dose of Beclomathasone (400mcg/day) combined with LABA (long acting beta agonists eg salmeterol)
The adults did slight better with the combination. Children did not.
So why should we care?
Well – consider the spike asthma deaths after the introduction of the early beta agonists? Or even some of the later ones http://www.ncbi.nlm.nih.gov/pubmed/1346340 and lots of others. Also consider that the creation of inhaled steroids was a strategy to reduce that spike in deaths that came with inhaled beta agonist use. Then – if short time acting beta agonists increased risk of death – what is likely to follow (eventually when enough data is collected) the use of the long acting beta agonists?
In the review study above – I wonder the comparison in effect if an increased dose of inhaled steroids was compared to the combination therapy? Eg compare 2000 mcg/day with 400mcg steroids + LABA? I would put money on a reversal of the slight benefit to combination in the short term.
The evidence that risk of hospital admission in children who are treated with LABAs are used is a big warning flag.
Of course, I am “biased”…
Because I don’t take any asthma medication. But I used to. Earlier this week I challenged myself to find the key that allowed me to become free of asthma. You may know that I teach workshops and have written books on Buteyko Method , and How To Grow Out of Asthma.
But I wanted to find the single concept that is the basis for those books and workshops. Because if I could find it and communicate it – it would help people change the way asthma is viewed. It would change it in a way that would allow many others to simply alter themselves, gently, safely and over time to ‘grow out of it.
So I thought back. What was the ONE thing that clicked when I was given a different pile of medical facts – that if I told it to you – you would not be able to think about your asthma in the current framework?
It would have to short. And proven by science. And simple.
And I did manage to get it into one single sentence. 15 words that will alter your view of asthma in such a way that you will be able to understand how people have asthma remission. How and why their asthma comes and goes. Why children get asthma after running around and when their noses are blocked.
Why dry air is better for some, and sea air better for other asthmatics? How adults can get asthma for the first time? How very fit athletes can get asthma? Why swimming sometimes helps? Why Yoga and stretching can help your asthma. Why changing your diet changes your asthma.
And lots more questions that modern medicine has not viable answer for. Really – if you have “hyperactive” airways only in the winter? Does that makes sense? And how can they become hyperactive/sensitive (or whatever) for the first time when you are 50 years old? And then can become non-hyperactive again?
And dust mites? They are ALWAYS on us. How can they SOMETIMES causes us to get asthma and not other times?
I considered just sharing my sentence. But experience has taught me – sadly, and you will agree – that people will not value free things. So to see my single sentence of 15 words – it is going to cost you $5. The $5 will go to charity – assuming anyone pays it. I know that I would – because if I had known this single sentence as a child – it would have shortened my “asthma career”.
I made the video below – it is a bit awful but you get the idea – because I was going to use Fiverr.com to share it – but Fiverr did not like the video for some reason – so here we are.
To discover the sentence – which I put into a 3 page report to set the scene and give so evidence links – which are to published articles and medical reference texts like Ganong – please go here: Click here
[Sorry for the extra click needed - but the Paypal doodad was easier to put there.]
Once you read the sentence – see you if you can figure out some better answers to the questions above – like ‘how can people grow out of asthma”? If you cannot – ask any child with asthma.
Good luck to you
James Hooper
How To Grow Out of Asthma As Quickly As Humanly Possible How To Grow Out Of Asthma As Quickly As Humanly Possible: Proven Simple Steps To Growing Out Of Asthma Using The Buteyko Method
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