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Annals of Internal Medicine tip sheet for June 6, 2006

1. Long-Acting Inhaled Beta-Agonists Increase Risk for Asthma Complications, Including Death

An meta-analysis of 19 published studies involving 33,826 asthma patients found that those receiving inhaled long-acting beta-agonists were 2.5 times more likely to be hospitalized and about two times more likely to have life-threatening asthma attacks than those receiving placebo.

Fifty-three of 3,083 patients receiving B-agonists were hospitalized for an asthma attack compared to 12 of 2,008 patients who received a placebo. The absolute increase in hospitalizations was one event per 71 patients treated per year.

Fifty of 15,443 patients receiving B-agonists had life-threatening asthma attacks compared to 25 of the 14,538 who received placebos.

While death from asthma was rare (thirteen deaths in the B-agonist group and three in the placebo group), those taking long-acting B-agonists died about 3.5 times as often as those receiving placebo.

The authors say that, "use of long-acting B-agonists could be associated with a clinically significant number of unnecessary hospitalizations, intensive care unit admissions, and deaths each year."

An editorialist notes that this analysis was not able to fully account for the effects of disease severity, co-treatments, adherence to treatment, or racial profile on the risk of poor outcomes. The editorialist suggests that physicians follow current guidelines which advise not using long-acting B-agonists as first line treatment for patients with "mild to moderate persistent asthma symptoms."

This article and editorial appear early online on June 6, 2006, and are available to the public at http://www.acponline.org. They will be published in the July 4, 2006, print edition of the journal.

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Contact: Susan Anderson
sanderson@acponline.org
215-351-2653
American College of Physicians
5-Jun-2006


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