William W. Busse, MD, from the University of Wisconsin School of Medicine and Public Health, chaired the expert panel which developed the government's 2007 National Asthma Education and Prevention Program Guidelines--even though he is financially linked to GlaxoSmithKline, Merck, Novartis, Pfizer Genentech/Novartis, Schering and five other Pharma companies. According to the guidelines themselves.
No wonder federal guidelines extol the "established beneficial effects of LABA for the great majority of patients who require more therapy than low-dose ICS alone to control asthma," and call LABAs a "preferred option" that "improves lung function, decreases symptoms [and] reduces exacerbations!" Not that we have an opinion.
Why is a Pharma doctor writing federal disease treatment guidelines? And why, on top of 10 Pharma backers, does he have "research support from the NIH" which is our tax-dollars? Aren't enough tax dollars buying Medicare and Medicaid-reimbursed LABAs thanks to the "guidelines"?
Since SMART and more reported deaths, the FDA has continued to hold hearings and tighten warnings. Currently, warnings say LABAs should only be used when inhaled corticosteriods don't control asthma, and for the shortest time possible and should not be used without corticosteriods or as a "rescue" medication.
Needless to say, if LABAs have to be used in addition to inhaled corticosteriods and in addition to rescue inhalers (like Proventil HFA, ProAir HFA, Ventolin HFA) what they are actually good for is not clear--even as Pharma sells a third, possibly surplus drug. No wonder Forbes magazine calls the LABA-containing Advair, "more a miracle of marketing than of science." Many also question whether the addition of an inhaled corticosteroid, which Symbicort, Dulera and Advair have, even makes them safer.
Of course, LABA promoters are furious about the warning that LABAs should not be used long term. "Suddenly stopping medication that is providing a protection for individuals--without good literature experience to back it up--is something we're very concerned about," said William Busse at an asthma conference. And when the FDA announced this year it will retest LABAs, Busse cowrote an angry letter to the New England Journal of Medicine. New trials are unnecessary he said and calling them "'safety' studies suggests that LABAs have some direct toxicity that causes death or leads to hospitalization."
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