SynthesisThorax2005
Anticholinergics in the treatment of children and adults with acute asthma: a systematic review with meta-analysis.
Synthesis in Thorax, 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 61 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
61 citing papers in PubMed, 7 syntheses or guidelines pooled it, 226 citations in OpenAlex.
- Combination of ipratropium bromide and salbutamol in children and adolescents with asthma: A meta-analysis.PloS one · 2021Pooled it
- Pooled it
- Combined inhaled beta-agonist and anticholinergic agents for emergency management in adults with asthma.The Cochrane database of systematic reviews · 2017Pooled it
- Combined inhaled anticholinergics and short-acting beta2-agonists for initial treatment of acute asthma in children.The Cochrane database of systematic reviews · 2013Pooled it
- Asthma and other recurrent wheezing disorders in children (acute).BMJ clinical evidence · 2012Pooled it
- Asthma in adults (acute).BMJ clinical evidence · 2011Pooled it
- Asthma in adults.BMJ clinical evidence · 2010Pooled it
- Efficacy and safety of ipratropium bromide/albuterol compared with albuterol in patients with moderate-to-severe asthma: a randomized controlled trial.BMC pulmonary medicine · 2016Trial
- Is Intravenous Magnesium Sulfate Beneficial in Children with Acute Asthma Exacerbation and Acute Bronchiolitis? A Retrospective Cohort Study.Children (Basel, Switzerland) · 2026Article
- Exacerbation of Asthma Among Pediatric Patients Presenting to the Emergency Department.Journal of clinical medicine · 2025Review
- Stepwise Management of Status Asthmaticus Refractory to Initial Therapy: A Case Report.Cureus · 2025Article
- Management of Asthma and COPD Exacerbations in Adults in the ICU.CHEST critical care · 2025Article
- Application of nano- and micro-particle-based approaches for selected bronchodilators in management of asthma.3 Biotech · 2024Review
- Open and Closed Triple Inhaler Therapy in Patients with Uncontrolled Asthma.Advances in respiratory medicine · 2023Review
- Epidemiology and Immunopathogenesis of Virus Associated Asthma Exacerbations.Journal of asthma and allergy · 2023Review
- Update on Long-Acting Anticholinergics in Children and Adolescents With Difficult and Severe Asthma.Frontiers in pediatrics · 2022Review
- Airway Redox Homeostasis and Inflammation Gone Awry: From Molecular Pathogenesis to Emerging Therapeutics in Respiratory Pathology.International journal of molecular sciences · 2020Review
- Chinese expert consensus-based guideline on assessment and management of asthma exacerbation.Journal of thoracic disease · 2019Review
- Future perspectives of anticholinergics for the treatment of asthma in adults and children.Therapeutics and clinical risk management · 2019Review
- Columbia Open Health Data, clinical concept prevalence and co-occurrence from electronic health records.Scientific data · 2018Article
1 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Erratum issued
- Erratum issued
- Erratum issued
- Erratum issued
Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCurrent guidelines recommend the use of a combination of inhaled beta(2) agonists and anticholinergics, particularly for patients with acute severe or life threatening asthma in the emergency setting. However, this statement is based on a relatively small number of randomised controlled trials and related systematic reviews. A review was undertaken to incorporate the more recent evidence available about the effectiveness of treatment with a combination of beta(2) agonists and anticholinergics compared with beta(2) agonists alone in the treatment of acute asthma.
methodsA search was conducted of all randomised controlled trials published before April 2005.
resultsData from 32 randomised controlled trials (n = 3611 subjects) showed significant reductions in hospital admissions in both children (RR = 0.73; 95% CI 0.63 to 0.85, p = 0.0001) and adults (RR = 0.68; 95% CI 0.53 to 0.86, p = 0.002) treated with inhaled anticholinergic agents. Combined treatment also produced a significant increase in spirometric parameters 60-120 minutes after the last treatment in both children (SMD = -0.54; 95% CI -0.28 to -0.81, p = 0.0001) and adults (SMD = -0.36; 95% CI -0.23 to -0.49, p = 0.00001).
conclusionsThis review strongly suggests that the addition of multiple doses of inhaled ipratropium bromide to beta(2) agonists is indicated as the standard treatment in children, adolescents, and adults with moderate to severe exacerbations of asthma in the emergency setting.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.