[Omeo33] Art 0733 - Homeopathy, 2007, 96 (2), 135-137

[Gino Santini]

Bronchodilators, fatal asthma, rebound effect and similitude
Marcus Zulian Teixeira

After the publication of my article ‘Evidence of the principle of  
similitude in modern fatal iatrogenic events’, new evidence was  
published which I brought to the attention of your readers through a  
Letter to the Editor. In a similar way to the non-steroidal anti- 
inflammatory drugs (NSAIDs), important new studies were recently  
published reinforcing the hypothesis that long-acting bronchodilators  
(β-agonists) may increase the risk for severe or fatal asthma  
exacerbations, as a consequence of the irreversible paradoxical  
bronchospasm (rebound effect of modern pharmacology or vital reaction  
of the homeopathic model).
After numerous scientific protests, since GlaxoSmithKline presented  
the partial data of the ‘Salmeterol Multicenter Asthma Research Trial  
(SMART)’ at the Annual International Scientific Assembly of The  
American College of Chest Physicians in 2003, claiming that ‘the  
interim analysis was inconclusive’, the full results of the 26, 355  
randomized subjects were published in 2006. Exploratory analyses of  
each outcome event within subpopulations were conducted, finding a  
significant increase in respiratory-related deaths (RR 2.16, 95% CI  
1.06–4.41) and asthma-related deaths (RR 4.37, 95% CI 1.25–15.34),  
and in combined asthma-related deaths or life-threatening experiences  
(RR 1.71, 95% CI 1.01–2.89) in subjects receiving salmeterol vs  
placebo. African-American subpopulation was particularly affected  
(compared with Caucasian subjects): respiratory-related deaths or life- 
threatening experiences (RR 4.10, 95% CI 1.54–10.90) and combined  
asthma-related deaths or life-threatening experiences (RR 4.92, 95% CI  
1.68–14.45) in subjects receiving salmeterol vs placebo.

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