Do beta-adrenergic blocking agents increase asthma exacerbation? A network meta-analysis of randomized controlled trials

Abstract Beta-adrenergic blocking agents (abbreviated as beta-blockers) have been used for treating various cardiovascular diseases. However, the potential for asthma exacerbation is one of the major adverse effects of beta-blockers. This study aimed to compare the level of risk for an asthma attack...

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Autores principales:	Kuo-Yang Huang, Ping-Tao Tseng, Yi-Cheng Wu, Yu-Kang Tu, Brendon Stubbs, Kuan-Pin Su, Yutaka J. Matsuoka, Chih-Wei Hsu, Ching-Hsiung Lin, Yen-Wen Chen, Pao-Yen Lin
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/e6a75dffe6ea4d42929cd2bcbf27e991
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spelling	oai:doaj.org-article:e6a75dffe6ea4d42929cd2bcbf27e9912021-12-02T14:01:20ZDo beta-adrenergic blocking agents increase asthma exacerbation? A network meta-analysis of randomized controlled trials10.1038/s41598-020-79837-32045-2322https://doaj.org/article/e6a75dffe6ea4d42929cd2bcbf27e9912021-01-01T00:00:00Zhttps://doi.org/10.1038/s41598-020-79837-3https://doaj.org/toc/2045-2322Abstract Beta-adrenergic blocking agents (abbreviated as beta-blockers) have been used for treating various cardiovascular diseases. However, the potential for asthma exacerbation is one of the major adverse effects of beta-blockers. This study aimed to compare the level of risk for an asthma attack in patients receiving various beta-blockers. We searched for randomized controlled trials (RCTs) of either placebo-controlled or active-controlled design. The current network meta-analysis (NMA) was conducted under a frequentist model. The primary outcome was the incidence of asthmatic attack. A total of 24 RCTs were included. Overall NMA revealed that only oral timolol [risk ratio (RR) = 3.35 (95% confidence interval (CI) 1.04–10.85)] and infusion of propranolol [RR = 10.19 (95% CI 1.29–80.41)] were associated with significantly higher incidences of asthma attack than the placebo, whereas oral celiprolol [RR = 0.39 (95% CI 0.04–4.11)], oral celiprolol and propranolol [RR = 0.46 (95% CI 0.02–11.65)], oral bisoprolol [RR = 0.46 (95% CI 0.02–11.65)], oral atenolol [RR = 0.51 (95% CI 0.20–1.28)], infusion of practolol [RR = 0.80 (95% CI 0.03–25.14)], and infusion of sotalol [RR = 0.91 (95% CI 0.08–10.65)] were associated with relatively lower incidences of asthma attack than the placebo. In participants with a baseline asthma history, in addition to oral timolol and infusion of propranolol, oral labetalol, oxprenolol, propranolol, and metoprolol exhibited significantly higher incidences of asthma attack than did the placebo. In conclusion, oral timolol and infusion of propranolol were associated with a significantly higher risk of developing an asthma attack in patients, especially in those with a baseline asthma history, and should be avoided in patients who present a risk of asthma. Trial registration: PROSPERO CRD42020190540.Kuo-Yang HuangPing-Tao TsengYi-Cheng WuYu-Kang TuBrendon StubbsKuan-Pin SuYutaka J. MatsuokaChih-Wei HsuChing-Hsiung LinYen-Wen ChenPao-Yen LinNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Kuo-Yang Huang Ping-Tao Tseng Yi-Cheng Wu Yu-Kang Tu Brendon Stubbs Kuan-Pin Su Yutaka J. Matsuoka Chih-Wei Hsu Ching-Hsiung Lin Yen-Wen Chen Pao-Yen Lin Do beta-adrenergic blocking agents increase asthma exacerbation? A network meta-analysis of randomized controlled trials
description	Abstract Beta-adrenergic blocking agents (abbreviated as beta-blockers) have been used for treating various cardiovascular diseases. However, the potential for asthma exacerbation is one of the major adverse effects of beta-blockers. This study aimed to compare the level of risk for an asthma attack in patients receiving various beta-blockers. We searched for randomized controlled trials (RCTs) of either placebo-controlled or active-controlled design. The current network meta-analysis (NMA) was conducted under a frequentist model. The primary outcome was the incidence of asthmatic attack. A total of 24 RCTs were included. Overall NMA revealed that only oral timolol [risk ratio (RR) = 3.35 (95% confidence interval (CI) 1.04–10.85)] and infusion of propranolol [RR = 10.19 (95% CI 1.29–80.41)] were associated with significantly higher incidences of asthma attack than the placebo, whereas oral celiprolol [RR = 0.39 (95% CI 0.04–4.11)], oral celiprolol and propranolol [RR = 0.46 (95% CI 0.02–11.65)], oral bisoprolol [RR = 0.46 (95% CI 0.02–11.65)], oral atenolol [RR = 0.51 (95% CI 0.20–1.28)], infusion of practolol [RR = 0.80 (95% CI 0.03–25.14)], and infusion of sotalol [RR = 0.91 (95% CI 0.08–10.65)] were associated with relatively lower incidences of asthma attack than the placebo. In participants with a baseline asthma history, in addition to oral timolol and infusion of propranolol, oral labetalol, oxprenolol, propranolol, and metoprolol exhibited significantly higher incidences of asthma attack than did the placebo. In conclusion, oral timolol and infusion of propranolol were associated with a significantly higher risk of developing an asthma attack in patients, especially in those with a baseline asthma history, and should be avoided in patients who present a risk of asthma. Trial registration: PROSPERO CRD42020190540.
format	article
author	Kuo-Yang Huang Ping-Tao Tseng Yi-Cheng Wu Yu-Kang Tu Brendon Stubbs Kuan-Pin Su Yutaka J. Matsuoka Chih-Wei Hsu Ching-Hsiung Lin Yen-Wen Chen Pao-Yen Lin
author_facet	Kuo-Yang Huang Ping-Tao Tseng Yi-Cheng Wu Yu-Kang Tu Brendon Stubbs Kuan-Pin Su Yutaka J. Matsuoka Chih-Wei Hsu Ching-Hsiung Lin Yen-Wen Chen Pao-Yen Lin
author_sort	Kuo-Yang Huang
title	Do beta-adrenergic blocking agents increase asthma exacerbation? A network meta-analysis of randomized controlled trials
title_short	Do beta-adrenergic blocking agents increase asthma exacerbation? A network meta-analysis of randomized controlled trials
title_full	Do beta-adrenergic blocking agents increase asthma exacerbation? A network meta-analysis of randomized controlled trials
title_fullStr	Do beta-adrenergic blocking agents increase asthma exacerbation? A network meta-analysis of randomized controlled trials
title_full_unstemmed	Do beta-adrenergic blocking agents increase asthma exacerbation? A network meta-analysis of randomized controlled trials
title_sort	do beta-adrenergic blocking agents increase asthma exacerbation? a network meta-analysis of randomized controlled trials
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/e6a75dffe6ea4d42929cd2bcbf27e991
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Do beta-adrenergic blocking agents increase asthma exacerbation? A network meta-analysis of randomized controlled trials

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