:: Volume 7, Issue 2 (4-2016) ::
Caspian J Intern Med 2016, 7(2): 64-70 Back to browse issues page
Efficacy and safety of conventional long acting β2- agonists: systematic review and meta-analysis
Reza Karbasi-Afshar, Jafar Aslani, Mostafa Ghanei *
Chemical Injuries Research Center, Baqiyatallah University of Medical Sciences; Tehran, Iran , prof.ghanei@gmail.com
Abstract:   (7383 Views)

Background: Chronic obstructive pulmonary disease (COPD) is usually considered one of the leading causes of death worldwide, so finding proper therapeutic strategies for this disease is of high importance. In this meta-analysis, we reviewed the existing literature on the efficacy and safety of conventional long acting beta agonists (LABAs) in COPD patients.

Methods: We searched MEDLINE and Google scholar to identify relevant articles. We limited data to double-blinded randomized controlled trials (RCTs). Data of 14, 832 COPD subjects including 7540 patients under a β2 agonist (cases) and 7292 taking placebo (controls) retrieved from 20 randomized controlled trials and were enrolled into this meta-analysis. Evaluated outcomes included overall mortality, exacerbations and tolerance to the drug.

Results: The analysis of survival showed no significant difference between those taking LABAs or placebo (relative risk (RR): 0.945, 95% confidence interval (CI): 0.821-1.088, P=0.432). Exacerbation rate, however, was significantly lower among the cases than among the controls (RR: 0.859, 95%CI: 0.800-0.922, p<0.001). Similar observation was detected in analyzing the rate of drug withdrawal in patients of the two groups with patients under placebo having significantly higher rate of drug discontinuation due to adverse events or disease symptoms (RR:0.821, 95% CI: 0.774-0.871; p<0.007).

Conclusion: In conclusion, we found that the use of conventional LABA therapy in COPD patients is associated with a lower exacerbation rate of the disease as well as higher tolerance to the drug, but no survival advantage is expectable. Substitution of LABAs with new agents is recommended.

Keywords: beta agonist, COPD, chronic obstructive pulmonary disease, meta analysis
Full-Text [PDF 360 kb]   (1944 Downloads)    
Type of Study: Review Article | Subject: Pulmonology
Received: 2014/12/17 | Accepted: 2015/12/9 | Published: 2016/03/8


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Volume 7, Issue 2 (4-2016) Back to browse issues page