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Meta analysis
Increased risk of asthma death with salmeterol monotherapy compared with placebo, but not with salmeterol plus inhaled corticosteroids compared with inhaled corticosteroids alone
  1. Gustavo J Rodrigo
  1. Correspondence to Gustavo J Rodrigo,
    Departamento de Emergencia, Hospital Central de las Fuerzas Armadas, Obligado 1180/203, Montevideo 11300, Uruguay; gurodrig{at}

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Weatherall and colleagues performed a meta-analysis of all randomised controlled trials of salmeterol included in the GlaxoSmithKline database to determine if its use was associated with an increased risk of asthma mortality (primary outcome) and whether inhaled corticosteroids (ICS) therapy influences any such risk. Three datasets were analysed: (1) salmeterol monotherapy (salmeterol vs placebo); (2) salmeterol with ICS (including ICS as randomised therapy or ICS as concurrent background medication) versus patients receiving ICS; and (3) salmeterol as combination salmeterol/fluticasone propionate versus ICS. On the basis of 215 studies with more than 100 000 patients, the authors found 35 deaths from asthma (all in adults) of which 86% came from two clinical trials.1,,2 The main results were …

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  • Competing interests GR has participated as a lecturer and speaker in scientific meetings and courses under the sponsorship of Boehringer Ingelheim, GlaxoSmithKline, AstraZeneca, Dr Esteve SA and Merck Sharp & Dome.