Get access

Short acting beta2-agonists for bronchiectasis

  • Review
  • Intervention

Authors


Abstract

Background

Bronchiectasis is a condition characterized by an abnormal and irreversible dilatation of the sub segmental airways and it may be caused by a variety of disease processes. Currently medical treatment includes physiotherapy, antibiotics and occasionally mucolytics. Many people with bronchiectasis receive bronchodilator therapy, since many people with the condition show signs of airflow obstruction and bronchial hyper-responsiveness. Evidence on effectiveness of bronchodilator therapy in bronchiectasis has only recently started to be systematically studied.

Objectives

The present review examined the effectiveness of short acting beta-2 agonist therapy in bronchiectasis, as this is the most frequently used treatment for airflow obstruction in people with this condition.

Search methods

We searched the Cochrane Airways Group Specialised Register. We also checked bibliographies of all identified RCTs to identify potentially relevant citations. Searches are current as of May 2008.

Selection criteria

All randomised controlled trials were considered for inclusion, whether single or double blind. The control group was placebo/no treatment or other drug/physical therapy. Participants could be children or adults diagnosed with bronchiectasis by plain-film chest radiograph, bronchography or high resolution computerized tomography. Patients were excluded if they had cystic fibrosis. Any type of short acting beta-2 agonist administered by inhalation or systemic route, used in conjunction with conventional treatment was included.

Data collection and analysis

In the absence of any relevant RCTs, we were unable to extract or analyse data.

Main results

We identified 48 articles by the search, the majority of which could be excluded on the basis of the abstract as they were not RCTs. Six articles were retrieved and were all excluded after careful consideration because they were either not RCTs or they did not deal with the question of interest.

Authors' conclusions

We failed to identify any RCTs investigating the role of short acting beta agonists in bronchiectasis. Since short acting beta-2 agonist therapy is the most frequently used treatment for airflow obstruction in bronchiectasis, there appears to be the need to investigate the effectiveness of this therapy using an RCT.

摘要

背景

以短效beta2促效劑治療支氣管擴張症

支氣管擴張症是一種以小支氣管呈異常且不可逆擴張的狀況,可以由不同的疾病過程所引起。目前的內科療法包括物理治療、抗生素及偶用化療藥,許多支氣管管擴張症患者接受支氣管擴張劑治療,此同許多患者呈現氣道阻塞的徵候及支氣管過度反應。支氣管擴張症使用支氣管擴張劑的療效的證據最近才開始作系統化的研究。

目標

本回顧文章審視短效beta2促效劑治療支氣管擴張症的療效,此為這類病人氣道阻塞最常用的治療。

搜尋策略

我們搜尋Cochrane Airways Group Specialised Register,我們亦檢視所有找到的隨機控制試驗的參考文獻以找出相關的論文。最近的搜尋是在2007年5月。

選擇標準

無論單盲或雙盲,所有隨機控制試驗均考慮納入。控制組為安慰劑/無治療或其他藥物/物理治療。參與者為以胸部X光片、支氣管鏡檢查或高解析度電腦斷層診斷為支氣管擴張症的兒童或成人,囊性纖維變性的患者則予排除。任何型式的短效2促效劑以吸入式全身用藥途徑使用且合併使用慣例治療均予納入。

資料收集與分析

因無任何相關的隨機對照研究,我們無法摘錄及分析數據。

主要結論

我們搜尋找出48篇論文,大多數從摘要中顯示並非隨機對照試驗而被排除,有6篇論文被提取檢視,但亦同非為隨機對照試驗或並非針對相關問題在經過慎重考慮後而全數排除。

作者結論

我們並未找到探討短效beta2促效劑對支氣管擴張症扮演角色之隨機控制試驗,由於短效beta2促效劑是用來治療支氣管擴張症的氣道狹窄最常用的藥物,故有需要以隨機控制試驗來研究其療效。

翻譯人

本摘要由中國醫藥大學附設醫院陳祖裕翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

沒有發現以短效beta2促效劑治療支氣管擴張症病患的隨機試驗。支氣管擴張症的特色是在肺內堆積粘液,這可以是其他氣道疾病如童年肺炎或結核病所引起。支氣管擴張症的內科療法包括物理治療、抗生素及偶有使用化療藥(這些藥物是用作清除肺中粘液)。由於許多支氣管擴張症病患呈現氣道不佳的徵候,故常使用吸入性支氣管擴張劑的治療。目前並無隨機對照試驗探討支氣管擴張劑在支氣管擴張症所扮演的角色。由於短效beta2促效劑是最常用於治療這類氣道阻塞的療法,故很需要有臨床試驗來探討其療效。

Plain language summary

No randomised trials were found testing short-acting beta-2 agonists in people with bronchiectasis.

Bronchiectasis is characterised by the build up of mucus in the lungs which can result from other airways disease such as childhood pneumonia or tuberculosis. Medical treatment for bronchiectasis includes physiotherapy, antibiotics and occasionally mucolytics (drugs which are used to try and clear the mucus in the lungs). Since many people with bronchiectasis show signs of poor airflow, bronchodilator therapy such as reliever inhalers is frequently prescribed. Currently there are no randomised controlled trials that investigate the role of these bronchodilators in bronchiectasis. Since short acting beta-2 agonist therapy is the most frequently used treatment for airflow obstruction in this condition, there appears to be a very great need to investigate the effectiveness of such therapy in clinical trials.

Get access to the full text of this article

Ancillary