Seretide

There's a wind of change in asthma treatment, or certainly as far as the marketing men are concerned. They've been sharpening their pencils to tell doctors about Seretide, a new asthma inhaler designed for sufferers who are not getting relief from low to moderate doses of inhaled steroids.

Best of all, they continue, the patient is likely to enjoy improvements from the very first day "which may aid compliance" doctor speak for saying the patient will be a good boy, and will continue the treatment. And at a cost to the NHS of nearly £67 for one pack of Seretide 500, that's pretty important.

For "wind of change", read "wind of haven't we seen this before somewhere", but of course that doesn't read quite as well. Seretide is a combination of two established Glaxo Wellcome asthma inhalers salmeterol and fluticasone propionate, marketed respectively as Serevent and Flovent.

There's no way of knowing just how new Seretide is compared to the combined drugs from which it has sprung, but it comes with its own bundle of side effects, some of which are shared with its parents. Typical reactions can include oral candidiasis, hoarseness, throat irritation, headache, palpitations, hypersensitivity, tremor, irregular heart rhythms, myalgia and muscle cramps.

Like most drugs, Seretide can also have a paradoxical effect in other words, it may cause the very symptoms it's supposed to be treating. And like other steroids, it can also cause growth retardation in adolescents, reduce bone mineral density or cause eye problems such as cataract or

glaucoma.

So if doctors do decide to introduce a wind of change into their asthma therapy, it looks as though they'll need to monitor their patients with great care or run the risk of reaping the whirlwind.