What Asthma Medications are Safe to Use During Pregnancy
- Saturday, July 18, 2009, 12:21
- Asthma
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- Andrew:
- How do we stand today? Do you have in your armamentarium, if you will, medications that you can use during pregnancy to control asthma that you feel comfortable with?
- Dr. Schatz:
- Yes. Fortunately, it’s a relief for everybody that although we certainly don’t have as much information as we would like or as could be – and we’ll talk about perhaps how to get more than that, based on the information that is available – there are a number of very effective medicines, some even relatively new medicines, that appear to have less or minimal risk, and therefore their benefit would outweigh the risks, and they should provide the type of control that’s necessary. Another important issue that people need to understand is that when you talk about safety of a medicine – probably in general, but certainly during pregnancy – you can’t talk in terms of absolute safety because you really can’t do the type of studies to prove that.
And an example that I think helps people understand is that if you were doing a study to prove a medicine’s safe during pregnancy, the way you would do it is you would take thousands of pregnant women – ideally with no underlying illness. Half of them, ideally, would get the medicines. Again, the reason that you’d ideally not have them have an underlying illness is you want to make sure that the illness itself doesn’t cause a problem.
So, half of them would get the medication, which by definition they wouldn’t need, half of them wouldn’t, and then you’d compare outcomes. That would be a way to prove a medicine is safe during pregnancy, but it would never happen. I mean, no IRB today or patient would feel that that’s ethical.
But in the absence of that, you can’t prove a medicine’s safe, and you have to look at less stringent information. And so you talk about suggestions of safety or information that would support the use without being able to say absolute. And with that in mind, there are medicines that have that sort of supported data that, again, it’s a push for trying to get more information.
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