SynthesisFrontiers in medicine2026
Comparative efficacy and safety of intravenous versus nebulized magnesium sulfate for acute asthma exacerbations: an overview of systematic reviews and meta-analyses.
Synthesis in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Who cites it
0 citing papers in PubMed.
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objective: This study aimed to conduct an umbrella review comparing intravenous versus nebulized magnesium sulfate for acute asthma exacerbations, providing evidence to guide route selection and clinical decision-making. Methods: We systematically searched PubMed, Embase, Cochrane Library, Web of Science, CNKI, VIP, WANFANG, and CBM from inception to August 2025, for systematic reviews/meta analyses comparing intravenous versus nebulized magnesium sulfate for acute asthma exacerbations. Overlap among primary studies was assessed using a citation matrix and corrected covered area. Quality assessment was performed using ROBIS, AMSTAR-2, PRISMA 2020, and GRADE. Quantitative and qualitative analyses of primary outcomes were performed. Results: A total of 18 systematic reviews/meta analyses were included. The corrected covered area was 5.168%, indicating some overlap in primary studies. ROBIS judged all studies at low risk of bias. AMSTAR-2 rated 6 studies as high quality, 2 as moderate, and 10 as low. PRISMA 2020 scores ranged from 25.5 to 41, with 10 studies of high and 8 of moderate reporting quality. GRADE yielded 13 high-quality, 38 moderate-quality, 27 low-quality, and 26 extremely low-quality outcomes. Conclusion: This overview clarifies the role of intravenous magnesium sulfate in acute asthma: not for routine use but as secondary adjunctive therapy for severe cases refractory to first-line treatment. The role of nebulized magnesium sulfate is more complex-neither universally applicable nor a replacement for first-line medications. Current evidence does not support routine use, warranting only a weak recommendation for patients who fail standard therapy. Future research should focus on its synergistic effects with other therapies and further elucidate its mechanisms. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/, PROSPERO: CRD420251122150.
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