The Editorial Executive Committee welcomes letters, which should be less than 250 words. Before a decision to publish is made, letters which refer to a published article may be sent to the author for a response. Any letter may be sent to an expert for comment. When letters are published, they are usually accompanied in the same issue by their responses or comments. The Committee screens out discourteous, inaccurate or libellous statements. The letters are sub-edited before publication. Authors are required to declare any conflicts of interest. The Committee's decision on publication is final.
Letter to the editor
Editor, – Professor Seale provides an informative and helpful account of the role of anti-leukotriene drugs in asthma (Aust Prescr 1999;22:58-60), contrasting with the somewhat irrational claims of their benefits in the lay press. It raises the issue of how to assess the benefits of asthma medication. A recent study1 advocated use of inhaled budesonide to prevent asthma relapse following discharge from the emergency department. Improved outcomes were measured by reduced relapse(defined as unscheduled visits for worsening symptoms), improved scores on an Asthma Quality of Life Questionnaire, and improved symptom scores. However there were no differences between treatment groups in measures of peak expiratory flow rates. If there is no difference in measured respiratory function, what is the significance of the other outcome measures, and what is the optimum method to assess if a patient is helped by a new intervention? If a patient says they feel better, possibly from a placebo effect of a perceived 'wonder drug', should they be continued on a new and expensive medication if there is no other measure of improvement?
- Rowe BH, Bota GW, Fabris L, Therrien SA, Milner RA, Jacono J. Inhaled budesonide in addition to oral corticosteroids to prevent asthma relapse following discharge from the emergency department: a randomized controlled trial. JAMA 1999;281:2119-26.