Magazine article Drug Topics

New Asthma Combo Offers Dual Approach

Magazine article Drug Topics

New Asthma Combo Offers Dual Approach

Article excerpt


Recognizing that both inflammation and bronchoconstriction play crucial roles in causing asthma symptoms, GlaxoSmithKline (GSK) will soon offer what it claims is the first medication that targets both of these components. Advair Diskus combines the long-acting beta2 agonist salmeterol (Serevent, GSK) with the anti-inflammatory, corticosteroid fluticasone propionate (Flovent, GSK).

"The beauty of this drug is 4 that you control the inflammation and you also have the smooth-muscle effects in a single, easy-to-use product Therefore, you can think of it as a two-hit system," said Christine Sorkness, Pharm.D., an investigator and professor of pharmacy and medicine at the University of Wisconsin.

According to Asthma in America, a landmark survey of patient and professional attitudes toward asthma in the United States, nearly three out of five persons with moderate persistent asthma overestimate how well controlled their asthma is, while almost one in three with severe persistent asthma mistakenly consider it to be well controlled. Sorkness has been surprised by the willingness of people to accept less than ideal control. "We must raise the bar of their expectations, and then we have to give them effective easy-to-use drugs to meet those expectations," she said. By having a product that will simultaneously treat both aspects of asthma with the convenience of one inhalation twice daily and the simplicity of the Diskus device, Sorkness believes it may make it easier for patients to adhere to therapy This, in turn, should result in better asthma control and a better quality of life.

The Food & Drug Administration has approved Advair Diskus for the long-term, twice-daily maintenance treatment of asthma in patients 12 years and older. Advair Diskus is not indicated for the relief of acute bronchospasm, and boldface labeling warns that it "should not be initiated in patients during rapidly deteriorating or potentially life-threatening episodes of asthma."

With the FDA granting Advair Diskus such a broad indication, who will benefit most? According to Sorkness, Advair Diskus is for the patient with persistent asthma who is clearly a candidate for an inhaled steroid or is not ideally controlled on a low dose of an inhaled steroid. "There have been several studies that have suggested increasing the dose of inhaled steroids would get you better control. But, alternatively, if you can keep the same dose of the inhaled steroid and add salmeterol, you will get better control of asthma," she added. She also noted that consistent clinical observations have shown that using an inhaled, long-acting beta^sub 2^ agonist with an inhaled corticosteroid provides better asthma control and causes fewer asthma exacerbations than does using a higher dose of inhaled corticosteroid alone. …

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