Physicians Weighing Patient Fallout Over FDA Panel’s Asthma Drug Vote

By DAN CHILDS, ABC News Medical Unit

Some respiratory specialists around the country have reported a flood of calls from concerned asthma patients after yesterday’s news of FDA panel votes on the safety of four widely used asthma drugs -- Advair, Symbicort, Serevent and Foradil.

This has more than a few specialists worried that the news could needlessly scare many patients away from needed medication. The following are some of the comments that the ABC News Medical Unit has received from these physicians:

Dr. David Lang, head of the Allergy/Immunology Section at the Cleveland Clinic’s Respiratory Institute:

"We're seeing an impact already in the sense that patients have heard about this in recent days, have interpreted what they've heard (or read) to imply that the medications they're taking... are potentially harmful, and have called our office asking whether they should stop taking these medications for their asthma. I am confident there are even more patients who aren't calling and may be inclined to stop the medications on their own.

"There is a need to clear the air and get the proper message out: asthma outcomes are superior with combination treatment (Advair or Symbicort) compared with inhaled steroid alone for patients with moderate-severe persistent asthma; don't stop taking your medication; if you're concerned talk to your asthma care provider."

Dr. Clifford Bassett, assistant clinical professor of medicine and otolaryngology at The Long Island College Hospital, SUNY-HSCB, in Brooklyn, NY:

"I have seen a pick up in phone calls regarding patients and their asthma medications over past several days; call volume is up by at least 50 percent and [I] expect it to continue.

"Some [patients] are unfortunately panicky about whether to continue any of asthma medications and are just hearing ‘scary stuff.’ The reality is, virtually all of my asthma patients are on the correct medication for their asthma and are doing just fine as they are adhering to a comprehensive allergy/asthma action plan."

Dr. John Murray, professor of medicine and pharmacology at Vanderbilt Medical School in Nashville, Tenn.:

"The worst thing about this sort of publicity is that some people won’t understand all the intricacies of the analyses and stop their asthma meds... The possible upside will be that more asthmatics may understand the importance and take inhaled steroids."

(Indeed, Murray adds that the votes should not have a drastic effect on clinical practice, at least in the near future -- even when it comes to Serevent and Foradil, which received the least favorable votes among the drugs the panel examined.)

Murray:

"I don’t think that either will be removed, as they are both indicated for COPD as well... And if they ‘removed’ Serevent or Foradil, they would also have to remove Brovana and Performist -- and these weren’t even considered at the advisory meeting as they only have an indication for COPD [chronic obstructive pulmonary disease]."

(And still others believe the votes will have little effect on patients’ feelings about the drugs.)

Dr. Neil Kao, chair of the Rhinitis/Sinusitis Committee of the American College of Allergy, Asthma & Immunology:

"This vote will have a very small effect on my practice... A high percentage of patients in my practice have asthma. Their asthma is controlled without the use of individual inhalers of [drugs like Serevent and Foradil] almost always. As the decision was just announced, there probably has not been enough time for the news to percolate through the medical community and general public. Technically, my office has not fielded a single question so far."

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