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Review: long acting β agonists increase severe asthma exacerbations and asthma related deaths in children and adults

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 Q In children and adults with asthma, do long acting β agonists (LABAs) increase severe asthma exacerbations requiring hospital admission, life threatening asthma attacks, and asthma related deaths?

Clinical impact ratings GP/FP/Primary care ★★★★★★☆ Internal medicine ★★★★★★☆ Allergy & immunology ★★★★★★☆ Emergency medicine ★★★★★☆☆ Respirology ★★★★★☆☆


Embedded ImageData sources:

Medline, EMBASE/Excerpta Medica, CINAHL, and Cochrane databases (all from 1966 to December 2005); references of selected reviews; and the US Food and Drug Administration website.

Embedded ImageStudy selection and assessment:

randomised controlled trials (RCTs) in any language that compared LABAs (salmeterol, formoterol, or eformoterol) with placebo and had ⩾3 month follow up. Patients were allowed to use short acting β agonists if needed. 19 RCTs (n = 33 826; mean age 37–38 y, 51% men) met the selection criteria. Quality assessment of individual studies was based on randomisation procedure, allocation concealment, blinding, dropouts and …

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  • For correspondence: Dr S R Salpeter, Santa Clara Valley Medical Center, San Jose, CA, USA. Salpeter{at}

  • Source of funding: no external funding.