Regular inhaled short acting β[sub 2] agonists for the management of stable chronic obstructive pulmonary disease: Cochrane systematic review and meta-analysis

Ram, F.S.F.; Sestini, P.
July 2003
Thorax;Jul2003, Vol. 58 Issue 7, p580
Academic Journal
Background: Despite the lack of reversibility, patients with chronic obstructive pulmonary disease (COPD) often report symptomatic improvement with inhaled short acting β[sub 2] agonist bronchodilators (ISABAs) in the management of both stable and acute exacerbations of COPD. A review of the literature was undertaken to determine the effectiveness of regular treatment with ISABAs compared with placebo in stable COPD. Methods: A search for randomised controlled trials was carried out using the Cochrane Collaboration database of trials up to and including May 2002. Results: Thirteen studies of 7 days to 8 weeks in duration on 237 patients aged 56-70 years with forced expiratory volume in 1 second (FEV[sub 1]) 60-70% predicted were included in the review. All studies used a crossover design with adequate washout periods and were of high methodological quality. ISABA was delivered either through a nebuliser or a pressurised metered dose inhaler. Spirometric tests performed at the end of the study and after the treatment (post-bronchodilator) showed a slight but significant increase in FEV[sub 1] and forced vital capacity (FVC) compared with placebo. In addition, both morning and evening peak expiratory flow rate (PEFR) were significantly better during active treatment than during placebo. An improvement in the daily breathlessness score was observed with ISABA treatment. The risk of treatment failure was reduced by more than 50% with ISABA. Preference for ISABA was nine times higher than for placebo. Conclusions: Use of ISABA on a regular basis for at least 7 days in patients with stable COPD is associated with improvements in post-bronchodilator lung function and decreases in both breathlessness and treatment failure. This review has shown that regular administration of ISABAs is an effective and inexpensive treatment for the management of patients with stable COPD.


Related Articles

  • Inhaled Salmeterol: A Review of its Efficacy in Chronic Obstructive Pulmonary Disease. Jarvis, B.; Markham, A. // Drugs & Aging;2001, Vol. 18 Issue 6, p441 

    Inhaled salmeterol is a long-acting, selective β-adrenoceptor agonist bronchodilator. The drug has been compared with placebo, ipratropium bromide and oral theophylline in patients with chronic obstructive pulmonary disease (COPD) in randomised, clinical trials. Inhaled salmeterol 50µg...

  • New COPD guidelines urge use of drug still under study. Hitchens, Kathy // Drug Topics;8/18/2003, Vol. 147 Issue 16, pHSE7 

    Reports on the Global Initiative for Chronic Obstructive Lung Disease's issuance of an updated guidelines chronic obstructive pulmonary disease (COPD). Recommendation of bronchodilator tiotropium for maintenance COPD therapy; Reclassification of the staging of COPD.

  • Bronchodilator reversibility testing in COPD.  // Thorax;Feb2004, Vol. 59 Issue 2, p178 

    A letter to the editor is presented in response to the article "Bronchodilator reversibility testing in chronic obstruction pulmonary disease," by Calverley, Burge, Spencer et al. published in a 2003 issue of the journal.

  • Long-Acting β Agonists in the Management of Stable Chronic Obstructive Pulmonary Disease. Cazzola, M.; Donner, C.F. // Drugs;Aug2000, Vol. 60 Issue 2, p307 

    Long-acting β agonist bronchodilators (e.g. formoterol, salmeterol) are a new interesting therapeutic option for patients with chronic obstructive pulmonary disease (COPD). In the short term, both salmeterol and formoterol appear to be more effective than short-acting β agonists, and in...

  • Economic burden of chronic obstructive pulmonary disease. Impact of new treatment options. Friedman, M.; Hilleman, D.E. // PharmacoEconomics;Mar2001, Vol. 19 Issue 3, p245 

    The incidence, morbidity and mortality of chronic obstructive pulmonary disease (COPD) is rising throughout the world. The total economic cost of COPD in the US in 1993 was estimated to be over $US15.5 billion, with $US6.1 billion for hospitalisation, $US4.4 billion for physician and other fees,...

  • Bronchodilators in COPD and Arrhythmias. Kuritzky, Louis // Internal Medicine Alert;9/15/2012, Vol. 34 Issue 17, p135 

    The article informs about a study based on the use of bronchodilators in chronic obstructive pulmonary disease (COPD) and arrhythmias.

  • An Update on Tiotropium for Chronic Obstructive Pulmonary Disease. Gupta, Rahul // Internal Medicine Alert;11/15/2008, Vol. 30 Issue 21, p163 

    The article presents a commentary to a study that determines the efficacy of adding tiotropium in bronchodilation in patients with moderate to very severe chronic obstructive pulmonary disease (COPD).

  • Bronchodilators in COPD and Arrhythmias.  // Neurology Alert;Oct2012 Clinical Briefs in Primary Care, p19 

    The article discusses bronchodilators in chronic obstructive pulmonary disease (COPD) for symptomatic relief and the relative low risk of arrhythmia for new users of methylxanthines.

  • Long-acting bronchodilators raise CV risk in COPD.  // Reactions Weekly;5/25/2013, Issue 1454, p3 

    An abstract of the case study regarding the risk of bronchodilators in elderly patients with chronic obstructive pulmonary disease (COPD) is presented.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics