SALMETEROLXINAFOATE (Serevent, Allen and Hanburys) is an inhaled beta-adrenergic agonist approved for mainte-nance asthma therapy in adults and children older than 12 years of age. The recommended dose is two inhalations (42 μg) twice daily. Its adverse effect profile is similar to that of albuterol; however, salmeterol has a prolonged, 12-hour duration of action. It may also have activity as an antiinflammatory agent, which may be beneficial in the treatment of asthma; however, the clinical relevance of these potential effects remains to be elucidated. As a new therapeutic agent for the treatment of asthma, its place in the hierarchy of asthma therapies is currently undefined and a number ofquestions may arise regarding its use.
Get full access to this article
View all access options for this article.
References
1.
Package insert. Serevent (salmeterol). Research Triangle Park, NC: Allen and Hanburys, Division of Glaxo, February 1994.
2.
BouletLP. Long- versus short-acting β2-agonists. Implications for drug therapy. Drugs1994; 47: 207–22.
3.
BilanciaRChianeseRFerranniniARicattiDGRoselliPGramiccioniE. Study of quality life of adult asthmatic patients treated with inhaled salmeterol or oral theophylline, preliminary data (abstract). Eur Respir J1993; 6 (suppl 17): 592s.
4.
UkenaDBraunHKoperIBrunsISybrechtGW. Treatment of nocturnal asthma: Salmeterol vs. theophylline (abstract). Chest1993; 104 (suppl): 29s.
5.
Salmeterol. Med Lett Drugs Ther1994; 36: 37–9.
6.
National Asthma Education Program. Guidelines for the diagnosis and management of asthma. Publication No. 91-3042. Bethesda, MD: Office of Prevention, Education, and Control; National Heart, Lung, and Blood Institute; National Institutes of Health; Public Health Service; US Department of Health and Human Services, August 1991.
7.
JohnsonM. β2-agonists as anti-inflammatory therapies in the lung. Agents ActionsSuppl1993; 41: 27–45.
LötvallJLundeHUllmanATönqvistHSvedmyrN. Twelve months, treatment with inhaled salmeterol in asthmatic patients. Effects on β2-receptor function and inflammatory cells. Allergy1993; 47: 477–83.
10.
TwentymanOPFinnertyJPHarrisAPalmerJHolgateST. Protection against allergen-induced asthma by salmeterol. Lancet1990; 336: 1338–42.
SpitzerWOSuissaSErnstPHorwitzRIHabbickBCockcroftD., The use of β-agonists and the risk of death and near death from asthma. N Engl J Med1992; 326: 501–6.
13.
MullenMLMullenBCareyM. The association between β-agonist use and death from asthma: A meta-analytic integration of case-controlled studies. JAMA1993; 270: 1842–5.
14.
SuissaSErnstPBoivinJFHorwitzRIHabbickBCockroftD., A cohort analysis of excess mortality in asthma and the use of inhaled β-agonists. Am J Respir Crit Care Med1994; 149: 604–10.
15.
CheungDTimmersMCZwindermanHBelEHDijkmanJHSterkPJ. Long-term effects of a long-acting β2-adrenoceptor agonist, salmeterol, on airway hyperresponsiveness in patients with mild asthma. N Engl J Med1992; 327: 1198–203.
16.
UllmanAHednerJSvedmyrN. Inhaled salmeterol and salbutamol in asthmatic patients. An evaluation of asthma symptoms and the possible developement of tachyphylaxis. Am Rev Respir Dis1990; 142: 571–5.
17.
BoothHFishwickKHarkawatRDevereauxGHendrickDJWaltersEH. Changes in methacholine induced bronchoconstriction with the long acting β2 agonist salmeterol in mild to moderate asthmatic patients. Thorax1993; 48: 1121–4.
18.
PearlmanDSChervinskyPLaForceCSeltzerJMSouthernDLKempJP, A comparison of salmeterol with albuterol in the treatment of mild-to-moderate asthma. N Engl J Med1992; 327: 1420–5.
19.
RamageLLipworthBJIngramCGCreeIADhillonDP. Reduced protection against exercise induced bronchoconstriction after chronic dosing with salmeterol. Respir Med1994; 88: 363–8.
20.
CastleWFullerRHallJPalmerJ. Serevent nationwide surveillance study: Comparison of salmeterol with salbutamol in asthmatic patients who require regular bronchodilator treatment. BMJ1993; 306: 1034–7.
21.
BunneyR. Study too small to detect increase in deaths (letter). BMJ1993; 306: 1610.
InmanWHW. Manufacturers underestimate mortality from asthma (letter). BMJ1993; 306: 1610.
24.
Executive Committee, American Academy of Allergy and Immunology. Position statement: Inhaled β2-adrenergic agonists in asthma. J Allergy Clin Immunol1993; 91: 1234–7.
