Do Inhaled Anticholinergic Agents in Addition to β-Agonists Improve Outcomes in Acute Asthma Exacerbations?

Abstract

Comparison of outcomes between combination therapy and b-agonist alone. Outcome Number of Studies (Number of Participants) RR (95% CI) MD (95% CI), % I 2 , % Hospitalization 16 (2,120) 0.72 (0.59-0.86) 12 % Change PEF 7 (551) 24.88 (14.83-34.93) 23 Relapse rates 5 (1,180) 0.8 (0.66-0.98) 0 Adverse events 11 (1,392) 2.03 (1.28-3.02)* 14 RR, Relative risk; CI, confidence interval; MD, mean difference; PEF, peak expiratory flow. *Odds ratio.

Acute Severe Asthma in Adolescent and Adult Patients: Current Perspectives on Assessment and Management

“…Severe exacerbations may occur in patients with mild or well controlled asthma [59,60]. However, poor asthma control is an independent risk factor for future acute exacerbations [61,62,63,64,65]. A history of a recent exacerbation is the strongest predictor of future exacerbations in children and adults with asthma [66,67,68,69].…”

“…It is not recommended to use anticholinergics as a single therapy for acute asthma. It has been demonstrated that the addition of inhaled ipratropium bromide to therapy with SABAs improve hospitalization rates, relapse rates and are associated with lung function improvement [62,63,64]. This combination therapy benefit is greater for the patients who present with acute severe asthma and are at a higher risk of hospitalization.…”