Cardiovascular Risk of the Use of Long-acting Bronchodilators in Patients with Asthma: A Meta-analysis of 22 Randomized Controlled Trials.

IF 8.2 1区医学 Q1 ALLERGY

Journal of Allergy and Clinical Immunology-In Practice Pub Date : 2025-03-06 DOI:10.1016/j.jaip.2025.02.035

Le Bai, Tingyuan Li, Dongwei Zhu, Qi Zhao, Yong Xu, Xianmei Zhou

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引用次数: 0

Abstract

Background: Long-acting bronchodilators can improve the control of asthma when added to inhaled corticosteroids (ICS). However, the cardiovascular safety of these drugs in patients with asthma has never been comprehensively evaluated. Notably, growing evidence have indicated a positive association between asthma and cardiovascular diseases.

Objective: To evaluate the cardiovascular safety of addition of long-acting bronchodilators in patients with asthma.

Methods: After a comprehensive retrieval in PubMed, Embase, Cochrane Library and Web of Science, we included randomized controlled trials that assessed the cardiovascular safety of long-acting bronchodilators in patients with asthma. The primary outcome was the comparation of incidence of total cardiovascular AEs. Secondary outcomes included drug-related AEs, AEs leading to discontinuation, serious AEs and fatal AEs.

Results: A total of 22 trials with 62,915 patients were included. The use of long-acting bronchodilators significantly increased the incidence of cardiovascular AEs leading to discontinuation (IRR: 3.05, 95% CI: 1.07-8.48). The incidences of total cardiovascular AEs, drug-related AEs, serious AEs and fatal AEs were higher in patients treated with long-acting bronchodilators, but the differences were not significant. The certainty of evidence was low for comparations of total cardiovascular AEs and fatal AEs. The certainty of evidence was very low for comparations of drug-related AEs, AEs leading to discontinuation and serious AEs.

Conclusion: The incidence of cardiovascular AEs was quite low in patients with asthma, and only the risk of AEs leading to discontinuation significantly increased compared with those not exposure to long-acting bronchodilators. More studies are required to confirm the present findings in consideration of the potential reporting bias.

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来源期刊

Journal of Allergy and Clinical Immunology-In Practice ALLERGYIMMUNOLOGY-IMMUNOLOGY

CiteScore

11.10

自引率

9.60%

发文量

683

审稿时长

50 days

期刊介绍： JACI: In Practice is an official publication of the American Academy of Allergy, Asthma & Immunology (AAAAI). It is a companion title to The Journal of Allergy and Clinical Immunology, and it aims to provide timely clinical papers, case reports, and management recommendations to clinical allergists and other physicians dealing with allergic and immunologic diseases in their practice. The mission of JACI: In Practice is to offer valid and impactful information that supports evidence-based clinical decisions in the diagnosis and management of asthma, allergies, immunologic conditions, and related diseases. This journal publishes articles on various conditions treated by allergist-immunologists, including food allergy, respiratory disorders (such as asthma, rhinitis, nasal polyps, sinusitis, cough, ABPA, and hypersensitivity pneumonitis), drug allergy, insect sting allergy, anaphylaxis, dermatologic disorders (such as atopic dermatitis, contact dermatitis, urticaria, angioedema, and HAE), immunodeficiency, autoinflammatory syndromes, eosinophilic disorders, and mast cell disorders. The focus of the journal is on providing cutting-edge clinical information that practitioners can use in their everyday practice or to acquire new knowledge and skills for the benefit of their patients. However, mechanistic or translational studies without immediate or near future clinical relevance, as well as animal studies, are not within the scope of the journal.