The FDA is not supposed to be in the business of practicing medicine. Their role related to medicine is to approve or not approve medications, and to warn doctors of potential problems with certain types of drugs. Some doctors are now expressing concern about the latest recommendation from the FDA, calling for earlier discontinuation of certain asthma drugs. The doctors, experts in the field of treating asthma, are saying that this recommendation may be very risky for some patients. They expressed their concern at press meeting held at the American Academy of Allergy, Asthma and Immunology (AAAAI) 2010 Annual Meeting.
Last month, the FDA came out with warnings about using certain types of asthma medications after a certain amount of time (FDA Urging Caution with Asthma Pumps). The FDA based their recommendations on the basis of a concern that these specific ones could actually mask worsening asthma symptoms, causing the eventual exacerbation (attack) to be much severe than it might have been if it had been caught earlier.
According to William W. Busse, MD, professor and chair of the Department of Medicine at the University of Wisconsin School of Medicine and Public Health in Madison, the new recommendations may lead to confusion among both doctors and patients.
The doctors do agree that the medications, such as Advair and Symbicort, which have long-acting beta agonists, or LABA, in them to help keep the airway open and Serevent and Foradi, which contain the LABA only, should not be used as monotherapy (one medication alone). However, the FDA recommendation to stop the medications once asthma control has been gained, runs against the guidelines for treating asthma and for keeping it under control, reducing the risk of an exacerbation.
So, has the FDA overstepped its boundaries? The doctors feel that educating the patients is of paramount importance. They also agree that patients who take these medications must be monitored appropriately. They don’t agree, however, on the recommendations and feel that it is up to the doctor to monitor the patients to see if there are improvements, if the medications are helping, and if there are any concerns. They are also quite concerned that some physicians may follow the FDA suggestions and stop the medications when they were being effective.