Prospective observational cohort safety study to monitor the introduction of a non-CFC formulation of salbutamol with HFA134a in England.
OBJECTIVE
To monitor the safety of a salbutamol MDI with a hydrofluoroalkane propellant (Ventolin Evohaler) during its introduction into primary care use in England.


METHODS
Prospective observational cohort study. 1,365 GPs in England submitted data on 10,472 regular users of Ventolin MDI, over five 3-month periods of observation between October 1, 1998 and December 31, 1999. The primary aim was to compare event rates occurring before and after the introduction of Ventolin Evohaler. The secondary aim was a comparison of event rates between users of Ventolin Evohaler and Ventolin MDI. The main outcome measures were: indication for use of Ventolin MDI, assessment of disease severity, event rates during each period of observation; deaths, pregnancies, reported adverse drug reactions and reasons for discontinuation of MDI. Event rates were adjusted using a ratio for under-reporting derived from a validation study on 4.6% of the study population and stratified by severity of indication.


RESULTS
The primary indication was asthma in 94%, distributed by severity as 47% mild, 44% moderate and 9% severe; 13% were children. By October 1999, 52.7% of the 8,973 remaining patients had transitioned to Ventolin Evohaler. There was no increase in major or minor events observed following the introduction of Ventolin Evohaler. No serious adverse events, abnormal pregnancy outcomes or deaths have been related to Ventolin MDI or Ventolin Evohaler. The validation study showed a degree of under-reporting.


CONCLUSIONS
These results on a large cohort of community patients in England indicate that Ventolin Evohaler is well tolerated among asthmatics.
Craig-McFeely
P M
PM
Drug Safety Research Unit, Southampton, UK. patrickcmf@doctors.org.uk
Wilton
L V
LV
Soriano
J B
JB
Maier
W C
WC
Shakir
S A W
SA
D000420:Albuterol / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001249:Asthma / Q000145:classification / Q000188:drug therapy*; D002626:Chemistry, Pharmaceutical; D002648:Child; D004739:England; D005260:Female; D006801:Humans; D006845:Hydrocarbons, Fluorinated / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D011446:Prospective Studies; D012720:Severity of Illness Index; D005466:Fluorocarbons
D000420:Albuterol; D006845:Hydrocarbons, Fluorinated; C094049:apaflurane; D005466:Fluorocarbons