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Is Chronic Use of β2-Agonists Detrimental in the Treatment of Asthma?

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Asthma: Epidemiology, Anti-Inflammatory Therapy and Future Trends

Part of the book series: Respiratory Pharmacology and Pharmacotherapy ((RPP))

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Abstract

A plethora of recent reviews testify to the controversy that has been generated in recent years by laboratory, clinical and epidemiological data challenging the wisdom of regular use of the short-acting β2-agonists which traditionally have formed the mainstay of treatment for bronchial asthma [1–5]. Although all national and international guidelines for the management of asthma now rec­ommend anti-inflammatory therapy for most patients with chronic symptoms [6–9], short-acting β2-agonists are still the most widely prescribed and most frequently used form of asthma treatment, and so the issue remains an impor­tant one. The prompt symptom relief afforded by these agents, together with the apparent lessening of side-effects such as tremor and tachycardia as more selective agents became available, led to almost universal acceptance of β2-agonist therapy in any required dosage to control clinical manifestations of asthma Surprisingly, this occurred in the absence of any substantial controlled clinical trials demonstrating their long-term efficacy or safety. A 1-week crossover trial of four times daily versus as-needed inhalation of salbutamol in 18 patients whose evening peak flow rates improved, but whose symptoms of cough and wheezing did not change, seems to have provided the basis for rec­ommending regular use of β2-agonists as maintenance treatment in asthma [10].

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Authors and Affiliations

  1. Department of Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand

    D. Robin Taylor

  2. Firestone Regional Chest and Allergy Unit, St.Joseph’s Hospital, McMaster University, Hamilton, Ontario, Canada, L8N 4A6

    Malcolm R. Sears

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  1. D. Robin Taylor
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Editors and Affiliations

  1. Department of Thoracic Medicine, Imperial College of Science, Technology and Medicine, National Heart and Lung Institute, London, SW3 6LY, England

    Mark A. Giembycz

  2. Clinical Studies Unit, The Royal Brompton National Heart and Lung Hospital, Sydney Street, London, SW3 6NP, England

    Brian J. O’Connor

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Taylor, D.R., Sears, M.R. (2000). Is Chronic Use of β2-Agonists Detrimental in the Treatment of Asthma?. In: Giembycz, M.A., O’Connor, B.J. (eds) Asthma: Epidemiology, Anti-Inflammatory Therapy and Future Trends. Respiratory Pharmacology and Pharmacotherapy. Birkhäuser, Basel. https://doi.org/10.1007/978-3-0348-8480-8_3

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  • DOI: https://doi.org/10.1007/978-3-0348-8480-8_3

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