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Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma

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Published on: November 4, 2010

Beta₂-agonists for exercise-induced asthma.

Matteo Bonini¹, Corrado Di Mambro, Moises A Calderon

¹Department of Public Health and Infectious Diseases, "Sapienza" University, Rome, Italy.

The Cochrane Database of Systematic Reviews

|October 4, 2013

Summary

Single-dose beta2-agonists effectively prevent exercise-induced asthma (EIA) in children and adults. However, long-term use of these medications can lead to tolerance and reduced effectiveness, with limited safety data available.

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Home-Based Prescribed Pulmonary Exercise in Patients with Stable Chronic Obstructive Pulmonary Disease

Home-Based Prescribed Pulmonary Exercise in Patients with Stable Chronic Obstructive Pulmonary Disease

Published on: August 24, 2019

Area of Science:

Pulmonology
Pharmacology
Exercise Physiology

Background:

Exercise can trigger asthma symptoms and bronchoconstriction, known as exercise-induced asthma (EIA).
Beta2-agonists are recommended for asthma management, but their efficacy and safety for EIA pretreatment remain debated.
EIA encompasses exercise-induced asthma and exercise-induced bronchoconstriction, regardless of underlying asthma diagnosis.

Purpose of the Study:

To evaluate the effectiveness and safety of inhaled short-acting beta2-agonists (SABA) and long-acting beta2-agonists (LABA) versus placebo for EIA pretreatment in children and adults.

Main Methods:

Systematic review and meta-analysis of randomized, double-blind, placebo-controlled trials.
Included studies assessed inhaled beta2-agonists for EIA in adults and children, with clear diagnostic criteria.
Searches of the Cochrane Airways Group Specialised Register and respiratory journals up to August 2013.

Main Results:

Fifty-three trials with 1139 participants were included.
Single-dose SABA and LABA demonstrated significant bronchoprotective effects against EIA compared to placebo (mean difference in FEV1 fall: -17.67%).
No significant difference in side effect occurrence was observed; however, long-term use of SABA and LABA led to tolerance and reduced efficacy.

Conclusions:

Low to moderate quality evidence supports the efficacy and safety of single-dose SABA and LABA for preventing EIA.
Long-term regular administration of inhaled beta2-agonists may induce tolerance and lacks sufficient safety data, particularly for LABA monotherapy.
Clinical relevance lies in the potential for overuse of beta2-agonists for EIA pretreatment despite safety concerns.