Safety of long-acting beta2-agonists in the treatment of asthma

Therapeutic Advances in Respiratory Disease
Mario Cazzola, Maria Gabriella Matera

Abstract

Several studies suggested an association between the regular use of beta2-agonists and asthma deaths. Whether this association represents adverse effects of beta -agonist use or is entirely due to disease severity is a matter of ongoing debate. Previous literature indicates that confounding by poor asthma control may explain the apparent deleterious effects of inhaled beta2-agonists. Tolerance to nonbronchodilator effects of beta2-agonists may account for the increase in reactivity to indirect bronchoconstrictor challenges and explain why some studies have demonstrated enhanced bronchoconstriction in patients with asthma after regular beta 2-agonist therapy. Nonetheless, the salmeterol multi-centre asthma research trial (SMART) found more asthma deaths (13 vs 3) and life-threatening asthma events (37 vs 22) in the salmeterol-treated asthmatic patients, although it was documented that among African-Americans, 5 times as many deaths and near-deaths from asthma occurred in those given salmeterol than in those given placebo, and among patients with asthma not using an inhaled corticosteroid (ICS) as a preventive (controller) medication, again more deaths and near-deaths from asthma occurred in those given salmeterol than in those g...Continue Reading

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Citations

May 5, 2011·Respirology : Official Journal of the Asian Pacific Society of Respirology·Yoshinosuke FukuchiDonald Tashkin
Jan 7, 2009·Therapeutic Advances in Respiratory Disease·James F DonohueK Denis-Mize
May 18, 2016·Yonsei Medical Journal·Jae Seung LeeSang Do Lee
May 23, 2012·Pharmacological Reviews·Mario CazzolaM Gabriella Matera
Jan 15, 2011·British Journal of Pharmacology·Mario CazzolaMaria Gabriella Matera
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Dec 19, 2019·Pharmacological Reviews·M G MateraM Cazzola
Oct 29, 2013·American Journal of Physiology. Lung Cellular and Molecular Physiology·Kamal SrivastavaXiu-Min Li
Jan 1, 2010·Expert Review of Clinical Pharmacology·Kenneth D Fitch
Aug 20, 2019·Respiratory Medicine·Mario CazzolaMaria Gabriella Matera

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