Treatment with salmeterol and inhaled corticosteroid should continue despite genotype
FRIDAY, Nov. 20 (HealthDay News) -- Outcomes in the long-acting β2 agonist in asthma trial showed no difference in treatment outcomes for patients taking salmeterol who had different B16 genotypes, according to a report in the Nov. 21 issue of The Lancet.
Michael E. Wechsler, M.D., of Brigham and Women's Hospital in Boston, and colleagues enrolled pairs of adult asthmatics with moderate disease, who were matched for ethnicity and one-second forced expiratory volume based on whether they carried the B16 Arg/Arg genotype or the B16 Gly/Gly genotype. The pairs were randomized for treatment with inhaled long-acting salmeterol or placebo in a crossover approach for two 18-week periods. All of the subjects received an inhaled corticosteroid.
At the end of 18 weeks, the researchers found that the mean morning peak expiratory flow among Arg/Arg subjects was 21.4 L/min higher for those receiving salmeterol than those receiving placebo, while for Gly/Gly subjects the difference was a nearly identical -- 21.5 L/min higher than those receiving placebo. Asthma exacerbations occurred in seven Arg/Arg subjects and six Gly/Gly subjects.
"These findings suggest that patients should continue to be treated with long-acting β2 agonists plus moderate-dose inhaled corticosteroids irrespective of B16 genotype," the authors write.
Several authors and the Brigham and Women's Hospital are listed as inventors of a patent concerning asthma genotype and salbutamol use. Several authors reported financial and consulting relationships with pharmaceutical companies.
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