Prescribing of β-adrenoceptor antagonists in asthma: an observational study

Daniel R. Morales, Bruce Guthrie, Brian J. Lipworth, Peter T. Donnan, Cathy Jackson (Lead / Corresponding author)

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    15 Citations (Scopus)

    Abstract

    Background: ß-Antagonists have recently been proposed for the treatment of chronic asthma; however, concerns regarding risk of acute bronchoconstriction in clinical trials remain. Objective: To determine the frequency of oral ß-blocker prescribing in patients with asthma and associations with severe asthma exacerbations requiring oral steroids in patients with active asthma defined by prior asthma-related medication use. Methods: Patients with asthma registered on 31 March 2007 and all asthma-related medications from the preceding 2 years were identified from anonymised clinical data from one-third of Scottish general practices. The main outcome measure was the relative incidence of active asthma patients receiving oral steroids following a new oral ß-antagonist prescription. Results: Of the 53 994 adult patients identified with asthma 1527 (2.8%; 95% CI 2.69% to 2.97%) patients were prescribed an oral ß-antagonist of which 441 (28.9%, 95% CI 26.7% to 31.2%) had active asthma and received a new ß-blocker prescription. The average number of patients prescribed rescue steroids at baseline in 367 patients with sufficient follow-up was 3.4 (0.9%) patients every 2 weeks. Rescue steroids were prescribed to 3 (0.8%) patients in the first 2 weeks and to 3 (0.8%) patients in the second 2 weeks following the new oral ß-antagonist (incidence rate ratio (IRR) 0.87, 95% CI 0.25 to 2.99 and IRR 0.89, 95% CI 0.26 to 2.97, respectively). No significant difference was found following stratification for ß-antagonist selectivity. Conclusion: These results suggest that prescribing new oral ß-blockers for the purpose of investigating potentially beneficial effects of chronic treatment would not lead to large increases in patients treated with oral steroids acutely in general practice.
    Original languageEnglish
    Pages (from-to)502-507
    Number of pages6
    JournalThorax
    Volume66
    Issue number6
    DOIs
    Publication statusPublished - Jun 2011

    Keywords

    • Blockers
    • Propanolol
    • Model
    • Responsiveness
    • Agonists
    • Disease

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