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Review: long acting β2 adrenoceptor agonists are effective in poorly reversible chronic obstructive pulmonary disease

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 Q In patients with chronic obstructive pulmonary disease (COPD) and poor reversibility to short acting bronchodilators, how effective are long acting β2 adrenoceptor agonists (LABAs)?

Clinical impact ratings GP/FP/Primary care ★★★★★☆☆ IM/Ambulatory care ★★★★★★★ Respirology ★★★★★★☆

METHODS

Embedded ImageData sources:

Medline, EMBASE/Excerpta Medica, CINAHL, Cochrane Central Register of Controlled Trials, Cochrane Airways Group Specialised Register (to July 2005), online registries of published and unpublished clinical trials, lists of conference abstracts, and bibliographies of relevant studies.

Embedded ImageStudy selection and assessment:

randomised controlled trials (RCTs) that compared inhaled LABAs (salmeterol or formoterol) given for ⩾4 weeks with placebo in patients who had stable, moderately severe COPD without asthma; FEV1 ⩽75% or FEV1/FVC ⩽70% of predicted value; poor reversibility after short dose short acting β2 agonist (⩽15% reversibility of FEV1 from baseline or as a percentage of predicted normal value); and no infections, exacerbations, or hospital admissions in the past month. Individual study quality was assessed using the 5 point Jadad scale. 23 RCTs (n = 6061, mean age range 58–72 y) met the selection criteria and had Jadad scores between …

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