SynthesisClinical reviews in allergy & immunology
Systematic review of clinical outcomes in chronic obstructive pulmonary disease: beta-agonist use compared with anticholinergics and inhaled corticosteroids.
Synthesis in Clinical reviews in allergy & immunology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 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
13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 36 citations in OpenAlex.
- Drugs with anticholinergic effects and cognitive impairment, falls and all-cause mortality in older adults: A systematic review and meta-analysis.British journal of clinical pharmacology · 2015Pooled it
- Inhaled corticosteroids and the risk of fractures in older adults: a systematic review and meta-analysis.Drug safety · 2008Pooled it
- Article
- In silico identification of a βProceedings of the National Academy of Sciences of the United States of America · 2022Article
- Practicing Sport in Cold Environments: Practical Recommendations to Improve Sport Performance and Reduce Negative Health Outcomes.International journal of environmental research and public health · 2021Review
- An overview of the benefits and drawbacks of inhaled corticosteroids in chronic obstructive pulmonary disease.International journal of chronic obstructive pulmonary disease · 2010Review
- Article
- Vasculitis: current status and future directions.Clinical reviews in allergy & immunology · 2008Article
- Cutting edge issues in autoimmunity.Clinical reviews in allergy & immunology · 2008Article
- Whither autoimmunity: the lessons of anti-CCP and B cell depletion.Clinical reviews in allergy & immunology · 2008Article
- Rebuttal: should we avoid beta-agonists for moderate and severe chronic obstructive pulmonary disease? Yes.Canadian family physician Medecin de famille canadien · 2007Article
- Should we avoid beta-agonists for moderate and severe chronic obstructive pulmonary disease? YES.Canadian family physician Medecin de famille canadien · 2007Article
- Bronchodilators in COPD: impact of beta-agonists and anticholinergics on severe exacerbations and mortality.International journal of chronic obstructive pulmonary disease · 2007Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Much controversy surrounds the use of beta-agonists in obstructive lung disease. Regular beta2- agonist use in asthma results in tolerance to its effects and an increase in asthma-related deaths. Less is known about clinical outcomes in chronic obstructive pulmonary disease (COPD). This systematic review and meta-analysis evaluates the long-term effect of beta2-agonist use on severe exacerbations requiring hospitalization or trial withdrawal, respiratory deaths, and total mortality in patients with COPD. Results for beta2-agonists are compared with results for anticholinergics and inhaled corticosteroids. Pooled results from randomized controlled trials show that anticholinergics, such as tiotropium and ipratropium, significantly reduce severe exacerbations and respiratory deaths compared with placebo. Conversely, beta2-agonists increase respiratory deaths, probably because of tolerance that develops to their bronchodilator and bronchoprotective effects. Anticholinergics significantly reduce exacerbations and total mortality compared with beta-agonists. The combination of the two bronchodilators is not more effective than anticholinergics alone in improving long-term clinical outcomes. Inhaled corticosteroids significantly reduce severe exacerbations and the decline in lung function over time, without affecting mortality. In conclusion, inhaled anticholinergic bronchodilators and corticosteroids should be used to improve long-term clinical outcomes in patients with COPD. beta-Agonists increase respiratory deaths in COPD, possibly as a result of poorer disease control.
Indexed as
Identifiers
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.