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

Franco F, Sheikh A, Greenstone M

Published Online:

July 16, 2008

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.

Abstract (click to read)

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 strategy:

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.

This record should be cited as:

Franco F, Sheikh A, Greenstone M. Short acting beta2-agonists for bronchiectasis. Cochrane Database of Systematic Reviews 2003, Issue 3. Art. No.: CD003572. DOI: 10.1002/14651858.CD003572

Assessed as up to date:

May 12, 2008

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Primary Review Group:

Airways Group

Health topics:

Lungs & airways > Bronchiectasis

Cochrane Summaries^beta

Independent high-quality evidence for health care decision making

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

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