Background: The regular administration of beta2-agonists may be associated with the development of tolerance to their effects.
Purpose: To assess the effect of regular beta2-agonist use on respiratory function and beta2-receptor function in asthmatic patients.
Data Sources: Comprehensive searches of the EMBASE, MEDLINE, and CINAHL databases from 1966 to June 2003 and references of identified articles and reviews.
Study Selection: Randomized, placebo-controlled trials that studied at least 1 week of regular beta2-agonist administration in patients with asthma and did not allow "as-needed" beta2-agonist use in the placebo group.
Data Extraction: Outcomes measured in the active treatment and placebo groups were the change in FEV1 in response to treatment and subsequent beta2-agonist administration, the provocative concentration of bronchoconstrictive agents causing a 20% reduction in FEV1 (PC20), and in vitro variables of leukocyte beta2-receptor function.
Data Synthesis: Pooled results of 22 trials showed that regular beta2-agonist use, compared with placebo, did not change the mean FEV1 after treatment or the net FEV1 treatment effect but substantially reduced the following: the peak FEV1 response to subsequent beta2-agonist administration (change, -17.8% [95% CI, -27.2% to -8.5%]); the FEV1 dose response to subsequent beta2-agonists (-34.8% [CI, -45.7% to -24%]); the PC20 to combined bronchoconstrictive stimuli (-26% [CI, -37% to -11%]); and leukocyte beta2-receptor density (-18.3% [CI, -31.6% to -5.1%]), binding affinity (-23.1% [CI, -39.4% to -6.8%]), and in vitro response to isoproterenol (-32.7% [CI, -56.5% to -9.0%]).
Conclusion: Regular beta2-agonist use for at least 1 week in patients with asthma results in tolerance to the drug's bronchodilator and nonbronchodilator effects and may be associated with poorer disease control compared with placebo.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.7326/0003-4819-140-10-200405180-00010 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Baseline Characteristics and Maintenance Therapy Choice on Symptom Control, Reliever Use, Exacerbation Risk in Moderate-Severe Asthma: A Clinical Modelling and Simulation Study.
Adv Ther
November 2024
GSK, 79 New Oxford St, London, WC1A 1DG, UK.
Introduction: Although some factors associated with asthma symptom deterioration and risk of exacerbation have been identified, these are not yet fully characterised. We conducted a clinical modelling and simulation study to understand baseline factors affecting symptom control, reliever use and exacerbation risk in patients with moderate-severe asthma during follow-up on regularly dosed inhaled corticosteroid (ICS) monotherapy, or ICS/long-acting beta-agonist (LABA) combination therapy.
Methods: Individual patient data from randomised clinical trials (undertaken between 2001 and 2019) were used to model the time course of symptoms (n = 7593), patterns of reliever medication use (n = 3768) and time-to-first exacerbation (n = 6763), considering patient-specific and extrinsic factors, including treatment.
A Review on Comparison of Allopathic Medicines to other Drug Therapies in the Management of Asthma.
Infect Disord Drug Targets
February 2024
School of Pharmacy, Maharaja Agrasen University, Atal Shiksha Kunj, Atal Nagar, Kalu Jhanda, Baddi, Solan, Himachal Pradesh 174103, India.
Article Synopsis
- * The review examines various asthma therapies, including Ayurvedic, Homeopathic, Unani, and Allopathic, highlighting that Allopathic methods like combination inhalers are the most effective for long-term management.
- * Allopathic treatments significantly reduce asthma attacks and improve lung function compared to other therapies, with the review offering case studies to support its superiority in asthma management.
Effect of monitoring adherence to regular inhaled corticosteroid (ICS) alone or in combination with a long-acting β2-agonist (LABA) using electronic methods on asthma outcomes: a narrative systematic review.
BMJ Open
August 2023
College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
Objectives: To evaluate through a systematic review the effectiveness of electronic methods in monitoring adherence to regular inhaled corticosteroids (ICS) alone or in combination with long-acting β2-agonists (LABAs) and their effect on clinical outcomes.
Design: A narrative systematic review.
Data Sources: MEDLINE, EMBASE, Cochrane Database of Systematic Reviews and Web of Science were searched through up to 10 July 2022.
Evaluating as-needed inhaled corticosteroid strategies in asthma: expanding the benefits to mild asthma.
Expert Rev Respir Med
November 2023
Respiratory Unit, Department of Translational Medicine, Sant'Anna University Hospital, Ferrara, Italy.
Introduction: Adherence to regular anti-inflammatory treatment is commonly low, and short-acting β2 agonist (SABA) overuse is common in patients with asthma, leading to an increased risk of asthma-related adverse events.
Areas Covered: Given the pivotal role of inflammation in asthma, multiple as-needed inhaled corticosteroid (ICS)-containing therapies have been developed, leading to a reduction in asthma exacerbations and improvement in symptom control. Currently, as-needed ICS/formoterol is one of the most commonly available formulations; however, other combinations such as ICS/SABA have been shown to be superior to as-needed SABA alone.
The efficacy and safety of additional treatment with short-acting muscarinic antagonist combined with long-acting beta-2 agonist in stable patients with chronic obstructive pulmonary disease: A systematic review and meta-analysis.
Chron Respir Dis
March 2023
Department of Respiratory Medicine, 12967Nara Medical University, Kashihara, Japan.
Background: The rationale for additional treatment with short-acting bronchodilators combined with long-acting bronchodilators for patients with chronic obstructive pulmonary disease (COPD) is not adequately studied.
Methods: We conducted a systematic review and meta-analysis to evaluate the efficacy and safety of a short-acting muscarinic antagonist (SAMA) therapy combined with a long-acting beta-2 agonist (LABA) in patients with stable COPD. Pulmonary function, dyspnea, health-related quality of life, exercise tolerance, physical activity, exacerbations of COPD, and adverse events during regular use were set as outcomes of interest.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!