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November 23, 1994

Salmeterol Xinafoate vs Albuterol in Asthma: Was Race a Factor?

Author Affiliations

University of Illinois Chicago

JAMA. 1994;272(20):1576. doi:10.1001/jama.1994.03520200032023

To the Editor.  —We read with interest the study by Dr D'Alonzo and colleagues.1 As pulmonary physicians who provide health care for inner-city, indigent minorities with asthma, we found the conclusion of the study, "Salmeterol inhaled twice daily is more effective than albuterol inhaled four times a day (or as needed) in patients with asthma requiring maintenance therapy," of particular significance to our patients. This is because some of these patients are not fully compliant with inhaled β2-agonist therapy administered four times a day and, thus, might be at risk for an acute asthma attack.However, we noticed that in Table 1 of the article the volunteers were not stratified according to race. We believe this point is important because it is well established that the mortality rate from asthma is higher amomg blacks than whites in the United States.2 For example, 429 persons died with

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