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Bronchodilators in COPD: Impact of β-agonists and anticholinergics on severe exacerbations and mortality
This review summarizes the long-term clinical outcomes associated with β-agonist and anticholinergic bronchodilator use in patients with chronic obstructive pulmonary disease (COPD). Pooled data from randomized placebo-controlled trials of at least three months duration were used to evaluate the ris...
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Formato: | Texto |
Lenguaje: | English |
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Dove Medical Press
2007
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2692116/ https://www.ncbi.nlm.nih.gov/pubmed/18044061 |
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author | Salpeter, Shelley R |
author_facet | Salpeter, Shelley R |
author_sort | Salpeter, Shelley R |
collection | PubMed |
description | This review summarizes the long-term clinical outcomes associated with β-agonist and anticholinergic bronchodilator use in patients with chronic obstructive pulmonary disease (COPD). Pooled data from randomized placebo-controlled trials of at least three months duration were used to evaluate the risk for COPD hospitalizations, respiratory mortality, and total mortality. The results show that anticholinergic use is associated with a 30% reduction in COPD hospitalizations, a 70% reduction in respiratory mortality, and without a significant effect on total mortality. In contrast, β-agonist use had no effect on COPD hospitalizations and was associated with a two-fold increased risk for respiratory death compared with placebo. When the two bronchodilators were directly compared with each other, β-agonists were associated with a two-fold increased risk for COPD hospitalization and a five-fold increased risk for total mortality compared with anticholinergics. When β-agonists were added to either anticholinergic use or inhaled corticosteroid use alone, there was no significant improvement in any long-term clinical outcome. These results indicate that anticholinergics should be the bronchodilator of choice in COPD, while β-agonists may be associated with poorer disease control. |
format | Text |
id | pubmed-2692116 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2007 |
publisher | Dove Medical Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-26921162009-06-16 Bronchodilators in COPD: Impact of β-agonists and anticholinergics on severe exacerbations and mortality Salpeter, Shelley R Int J Chron Obstruct Pulmon Dis Review This review summarizes the long-term clinical outcomes associated with β-agonist and anticholinergic bronchodilator use in patients with chronic obstructive pulmonary disease (COPD). Pooled data from randomized placebo-controlled trials of at least three months duration were used to evaluate the risk for COPD hospitalizations, respiratory mortality, and total mortality. The results show that anticholinergic use is associated with a 30% reduction in COPD hospitalizations, a 70% reduction in respiratory mortality, and without a significant effect on total mortality. In contrast, β-agonist use had no effect on COPD hospitalizations and was associated with a two-fold increased risk for respiratory death compared with placebo. When the two bronchodilators were directly compared with each other, β-agonists were associated with a two-fold increased risk for COPD hospitalization and a five-fold increased risk for total mortality compared with anticholinergics. When β-agonists were added to either anticholinergic use or inhaled corticosteroid use alone, there was no significant improvement in any long-term clinical outcome. These results indicate that anticholinergics should be the bronchodilator of choice in COPD, while β-agonists may be associated with poorer disease control. Dove Medical Press 2007-03 2007-03 /pmc/articles/PMC2692116/ /pubmed/18044061 Text en © 2007 Dove Medical Press Limited. All rights reserved |
spellingShingle | Review Salpeter, Shelley R Bronchodilators in COPD: Impact of β-agonists and anticholinergics on severe exacerbations and mortality |
title | Bronchodilators in COPD: Impact of β-agonists and anticholinergics on severe exacerbations and mortality |
title_full | Bronchodilators in COPD: Impact of β-agonists and anticholinergics on severe exacerbations and mortality |
title_fullStr | Bronchodilators in COPD: Impact of β-agonists and anticholinergics on severe exacerbations and mortality |
title_full_unstemmed | Bronchodilators in COPD: Impact of β-agonists and anticholinergics on severe exacerbations and mortality |
title_short | Bronchodilators in COPD: Impact of β-agonists and anticholinergics on severe exacerbations and mortality |
title_sort | bronchodilators in copd: impact of β-agonists and anticholinergics on severe exacerbations and mortality |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2692116/ https://www.ncbi.nlm.nih.gov/pubmed/18044061 |
work_keys_str_mv | AT salpetershelleyr bronchodilatorsincopdimpactofbagonistsandanticholinergicsonsevereexacerbationsandmortality |