Sammanfattning
BACKGROUND: Since their introduction more than 50 years ago, use of β-agonists for inhalation has been associated with increased mortality. Since the turn of the century, particular concern has been voiced regarding long-acting β2-selective agonists. Our purpose was to investigate the evidence from recently published randomised trials of possible increased risks of death and serious adverse events related to exposure to these drugs.
MATERIAL AND METHOD: A PubMed search identified ten clinical trials which fulfilled predefined inclusion criteria.
RESULTS: The ten trials encompassed 66 664 patients. A total of 16 asthma-related deaths after exposure to long-acting β2-selective agonists were recorded among 33 043 actively treated patients, whereas four such deaths were recorded among the 33 621 patients in the control groups. A single, large, pragmatic trial accounts for a majority of these fatalities.
INTERPRETATION: Exposure to long-acting β2-selective agonists is associated with a small increase in mortality. Whether concomitant use of inhalation steroids fully reverses this effect is not clear.