Posted: 18 Feb 2010 04:03 PM PST

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WASHINGTON (Reuters) - U.S. health officials said Thursday they were taking steps to reduce the use of certain asthma drugs because of serious risks, including death.

Inhaled medicines known as long-acting beta-agonists, or LABAs, must carry warnings saying they should never be used alone to treat asthma, the Food and Drug Administration said.

LABAs are sold as Glaxo's Serevent and Novartis AG's Foradil, which Merck & Co Inc markets in the United States. Two more widely used blockbuster medicines -- GlaxoSmithKline Plc's Symbicort -- combine a LABA with an inhaled corticosteroid.

The combination products should only be used in patients with asthma that cannot be controlled by other medications and should be used for the shortest time possible, FDA officials said. The agency said it will require new warnings that reflect that advice.

"The idea here is to overall decrease the use of long-acting beta agonists even as a combination product," Dr. Badrul Chowdhury, head of the FDA's pulmonary drugs division, told reporters on a conference call.

The FDA said a review found "there is an increased risk for severe exacerbation of asthma symptoms, leading to hospitalizations in pediatric and adult patients, as well as death in some patients" who used LABAs to treat asthma.

An FDA analysis presented to an advisory panel in December 2008 found 2.8 more serious asthma-related complications, including deaths and hospitalizations, for every 1,000 patients treated with a LABA.

The agency said on Thursday there was "no conclusive evidence that the combination of an asthma controller medicine with a LABA decreases or eliminates the risk." The FDA is requiring studies by the manufacturers to better understand the safety of LABAs when used with an inhaled steroid. Continued...

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One in two children has chronic health issues - WBOC

Posted: 17 Feb 2010 09:48 PM PST

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By Serena Gordon
HealthDay Reporter

TUESDAY, Feb. 16 (HealthDay News) -- One in every two U.S. children now grapples at some time with a chronic health condition, such as asthma, attention-deficit hyperactivity disorder (ADHD) or obesity, new research suggests.

The good news is that for many of those children, their chronic childhood illness won't persist. Just over 7 percent of those who reported a chronic condition at the beginning of the study still had the condition six years later.

"Over time, we found the rates of chronic conditions and obesity in U.S. children increased, but quite a few of these conditions resolved on their own," said study author Dr. Jeanne Van Cleave, a pediatrician at MassGeneral Hospital for Children in Boston.

The findings are published in the Feb. 17 issue of the Journal of the American Medical Association.

A chronic health condition is one that lasts at least 12 months, according to the study. Some of the conditions included asthma, type 1 diabetes, type 2 diabetes, epilepsy, cystic fibrosis, heart problems, allergic conditions, learning disabilities, hyperactivity, sinus infections, ear infections and more. Obesity was defined as a body-mass index in the 95th percentile or higher for the child's gender and age.

The researchers conducted the study using three different groups of children. The first cohort, which included 2,337 children, was interviewed during 1988 to 1994; the second, which included 1,759 children, was interviewed during 1994 to 2000 and the final group, which included 905 children, was interviewed from 2000 to 2006.

At the beginning of each period, the children were between the ages of 2 and 8; chronic conditions were confirmed by reports from parents.

At the end of each study, the prevalence of chronic illness or obesity was 12.8 percent in the first (earliest) group, 25 percent for the second group and 26.6 percent for the third (and most recent) group. The third group also had the highest prevalence of reporting a chronic condition at any time during the six-year study period, with 51.5 percent reporting a chronic condition at some point during the study.

The risk of having a chronic condition was higher for males, and for children who were black or Hispanic. Kids who had overweight mothers were far more likely to be overweight themselves, according to the study.

What surprised the authors, however, was that the chronic conditions weren't always lasting. Overall, only 7.4 percent of the children who had a chronic condition at the start of the study still had that same condition at the end of the research period.

"We've always thought of chronic conditions as quite permanent, so these findings give a lot of hope for kids with chronic conditions and obesity," said Van Cleave.

She said these findings also raise a number of research questions, as well as point to the need for good health care, including prevention and education services.

"It's likely that a lot of these conditions resolved because families made lifestyle changes, such as eating healthier foods, reducing screen time and becoming more physically active," she said.

"The burden of chronic disease in children is pretty high," said Dr. Geetha Raghuveer, a cardiologist and an associate professor at Children's Mercy Hospital in Kansas City, Mo.

Raghuveer said she isn't sure how much of the fluctuation in chronic conditions is real, because they're based on parental reports. "Some of the major issues here, like established childhood obesity, don't fluctuate and go away in our experience without a rigorous attempt. Although it's probably reassuring that at least some of these conditions may go away in time," she said.

But the bottom line, she said, is that U.S. children need better health habits. "This is just another study emphasizing what many already knew. And, if we don't eradicate the root causes, such as bad eating and little exercise, we'll continue to see a lot more morbidity in children," Raghuveer said.

"I'm seeing more and more kids with high cholesterol and insulin resistance that already have blood vessel damage in them. They're already like a 45-year-old in terms of blood vessel health. We need a basic change in how we live and how we eat. Prevention is key," she stressed.

More information

To learn more about raising healthy children, visit the U.S. Centers for Disease Control and Prevention.

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Asthma in Haifa children more than double the national average - Haaretz.com

Posted: 25 Feb 2010 03:59 AM PST

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The researchers linked the high incidence of asthma to the area's severe air pollution and a growing problem of obesity among schoolchildren. In Kiryat Yam, for instance, not only was the incidence of asthma even higher than the norm for the area, but the proportion of overweight children, at 12 percent, was almost three times the average for the Haifa Bay area.

Indeed, the researchers concluded that obesity is even more closely linked to asthma than pollution is. A quarter of the area's overweight children were found to have asthma, compared to 16 percent of children with normal weights. Boys were also found to be more prone to asthma than girls.

Though the incidence of asthma in the Haifa Bay area is higher than the national average, it is similar to that in other Western countries. In the United States, for instance, 22 percent of children have asthma, while 21 percent have the disease in Britain and 18 percent in Canada.

Several international studies have previously found a link between pollution and asthma, and have also discovered that some people have a genetic predisposition to the disease. The current study found that greater exposure to sulfur dioxide - which is produced by the fuel burned in Bay-area factories - increased the risk of asthma among children in the Haifa area by 11 percent, and in Kiryat Yam specifically by 37 percent. Increased exposure to other pollutants produced by the organic compounds burned in many Bay-area plants increased the risk of asthma in the area's children by 8 percent.

Though Health Ministry researchers were involved in the study, senior ministry officials expressed reservations about it yesterday.

"Even though a higher incidence of asthma was found compared to other studies that have examined other regions in Israel, the method for measuring the incidence of asthma was different than that used in the other studies," one explained.

Moreover, he noted, the link to air pollution was not proven definitively, since obesity was also identified as a risk factor.

Nevertheless, he said, "the Health Ministry is in favor of reducing air pollution as much as possible."

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Health Asthma

Thursday, February 25, 2010

plus 2 more, “FDA requires new warnings for asthma drugs - Reuters UK”

plus 2 more, “FDA requires new warnings for asthma drugs - Reuters UK”

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