Impact of Preventive Treatment With Long-Acting β<inf>2</inf>-Adrenergic Agonists and Inhaled Corticosteroids on the Morbidity and Mortality of Severe Asthma Exacerbations in 1543 Patients

Vicente Plaza, Jesús Bellido-Casado, Gustavo J. Rodrigo, Javier Solarte, Gema Rodríguez-Trigo, Ricardo Sepúlveda, Hugo Neffen, Miguel Perpiñá

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Abstract

Background and Objectives: Recent systematic reviews and meta-analyses examining long-acting #b2-adrenergic agonists (LABA) as maintenance treatment for asthma have shown surprisingly conflicting results. The aim of the present study was to determine the impact, in terms of efficacy and safety, of previous maintenance treatment on severe asthma exacerbations. Patients and Methods: We retrospectively evaluated the clinical characteristics of exacerbations experienced by 1543 patients with moderate persistent and severe persistent asthma. Drug therapy was as follows: a combination of inhaled LABAs and corticosteroids (493 patients), an inhaled corticosteroid only (456 patients), and no maintenance treatment (594 patients). Results: Asthmatic patients taking LABAs did not show higher mortality, longer stay in the intensive care unit, longer hospital stay, lower pH, or worse airflow obstruction than the other 2 groups. On the contrary, they had a higher mean (SD) forced expiratory volume in 1 second at discharge (54% [16%]) than patients taking inhaled corticosteroids (48% [19%]) and patients taking no maintenance treatment (48% [20%]) (P=.009). Patients taking no maintenance treatment also had lower mean (SD) pH values (7.37 [0.11]) than patients taking LABAs (7.39 [0.09]) and patients taking inhaled corticosteroids (7.39 [0.08]) (P=.002), and more admissions to the intensive care unit (11.1% vs 6.5% and 7.7%; P=.002 and P=.018, respectively). Conclusions: This study did not reveal higher morbidity or mortality in severe asthma exacerbations in patients with moderate persistent or severe persistent asthma who had received inhaled LABAs combined with inhaled corticosteroids. On the contrary, asthma patients who did not use maintenance treatment experienced more severe asthma exacerbations. © 2009 SEPAR.
Original languageEnglish
Pages (from-to)545-549
JournalArchivos de Bronconeumologia
Volume45
Issue number11
DOIs
Publication statusPublished - 1 Jan 2009

Keywords

  • Asthma
  • Inhaled corticosteroids
  • Morbidity
  • Mortality
  • Preventive treatment of asthma
  • Severe asthma exacerbation

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