Therapeutics
Addition of salmeterol to usual asthma pharmacotherapy may increase respiratory related deaths or life threatening experiences
Nelson HS, Weiss ST, Bleecker ER, et al. The Salmeterol Multicenter Asthma Research Trial: a comparison of usual pharmacotherapy for asthma or usual pharmacotherapy plus salmeterol. Chest 2006;129:15–26.
Q In patients with asthma, is the addition of salmeterol to usual pharmacotherapy safe?
Allergy & immunology Respirology
Key Words: asthma • glucocorticoids • adrenergic beta-agonists • albuterol • 46 • 210
| The first 150 words of the full text of this article appear below. |
Design:
randomised placebo controlled trial (Salmeterol Multicenter Asthma Research Trial [SMART]).
Allocation:
{concealed}*.
Blinding:
blinded (patients, healthcare providers, {data collectors}*, outcome assessors, and {data analysts}*).
Follow up period:
28 weeks.
Setting:
6163 sites in the US.
Patients:
26 355 patients 
12 years of age (mean age 39 y, 63% women) who were diagnosed with asthma and currently receiving prescription asthma medication. Exclusion criteria included previous use of inhaled long acting ß2 agonists and history of adverse reactions to sympathomimetic amine drugs.
Intervention:
salmeterol, 42 µg, twice daily (on arising and before bed) by metered dose inhaler (MDI) (n = 13 176) or placebo (n = 13 179) for 28 weeks. All patients continued use of current asthma medications.
Outcomes:
composite primary end point was respiratory related death or life threatening experience (ie, intubation and mechanical ventilation); secondary end points included all cause death, asthma related death, respiratory
Medical College of Wisconsin,
Milwaukee, Wisconsin, USA
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