Salmeterol: a study by prescription-event monitoring in a UK cohort of 15,407 patients
Abstract
To examine the safety of the long-acting beta2-agonist, salmeterol, in general medical practice in the U.K. In Prescription-Event Monitoring (PEM) the exposure data are derived from prescriptions confidentially provided by the Prescription Pricing Authority. Outcome data are obtained by questionnaires (green forms) on which prescribing medical practitioners recorded event (safety) data. Additional information is obtained from the patients' lifetime clinical records, from follow-up of all pregnancies, and from death certificates. PEM provides an observational cohort study in which there is no interference with the medical decision on which drug is prescribed for individual patients. A total of 15,407 patients were given salmeterol and observed for a minimum of 1 year. Headache, tremor, and palpitations were associated with the use of salmeterol. No unexpected major adverse events were noted, although in this study there was a total of 1022 deaths. Of these, 73 were due to asthma, but only 39 of these patients were taking salmeterol in the last month of life. All of these deaths appear on careful examination of the clinical records to have been due to natural causes, although in a minority (four, 10%) of the group of 39 subjects,...Continue Reading
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