The Experts below are selected from a list of 42 Experts worldwide ranked by ideXlab platform
Nils Svedmyr - One of the best experts on this subject based on the ideXlab platform.
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Salmeterol: An inhaled /β_2-agonist with prolonged duration of action
Lung, 1993Co-Authors: Jan Lötvall, Nils SvedmyrAbstract:Salmeterol (Serevent) is an inhaled beta_2-receptor agonist with more than twelve hours’ effect duration compared with 4–6 hours for the more short-acting substances Bitolterol, fenoterol, salbutamol, and terbutaline. Salmeterol has been studied in several large-scale double-blind multicenter studies with up to one year’s duration. More than 6,000 asthmatics have been treated with salmeterol during these controlled studies. All studies show salmeterol to have a significantly better and well-maintained bronchodilating effect with better asthma control, fewer asthma exacerbations, and a decreased need for rescue albuterol inhalations used on demand compared to the treatments in the control groups (200–400 μg albuterol q.i.d., inhaled albuterol given only p.r.n., terbutaline given regularly, or individually titrated slow-release theophylline). Salmeterol should be given b.i.d. and in combination with inhaled corticosteroids. Salmeterol seems especially effective in patients with nocturnal symptoms, exercise induced asthma, and in patients sensitive to inhaled irritants such as cold air. The patients should always have short-acting inhaled beta2-agonists available for break-through attacks. Inhaled salmeterol in combination with inhaled steroids seems to give the best maintenance asthma control available by inhalation today.
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Salmeterol: an inhaled beta 2-agonist with prolonged duration of action.
Lung, 1993Co-Authors: Jan Lötvall, Nils SvedmyrAbstract:Salmeterol (Serevent) is an inhaled beta2-receptor agonist with more than twelve hours’ effect duration compared with 4–6 hours for the more short-acting substances Bitolterol, fenoterol, salbutamol, and terbutaline. Salmeterol has been studied in several large-scale double-blind multicenter studies with up to one year’s duration. More than 6,000 asthmatics have been treated with salmeterol during these controlled studies. All studies show salmeterol to have a significantly better and well-maintained bronchodilating effect with better asthma control, fewer asthma exacerbations, and a decreased need for rescue albuterol inhalations used on demand compared to the treatments in the control groups (200–400 μg albuterol q.i.d., inhaled albuterol given only p.r.n., terbutaline given regularly, or individually titrated slow-release theophylline). Salmeterol should be given b.i.d. and in combination with inhaled corticosteroids. Salmeterol seems especially effective in patients with nocturnal symptoms, exercise induced asthma, and in patients sensitive to inhaled irritants such as cold air. The patients should always have short-acting inhaled beta2-agonists available for break-through attacks. Inhaled salmeterol in combination with inhaled steroids seems to give the best maintenance asthma control available by inhalation today.
Peter G. Gibson - One of the best experts on this subject based on the ideXlab platform.
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The Cochrane Library - Long-acting beta2-agonists versus theophylline for maintenance treatment of asthma.
The Cochrane database of systematic reviews, 2007Co-Authors: Augustine Tee, Mariko Siyue Koh, Peter G. Gibson, Toby J Lasserson, Amanda Wilson, Louis B. IrvingAbstract:BACKGROUND Theophylline and long acting beta-2 agonists are bronchodilators used for the management of persistent asthma symptoms, especially nocturnal asthma. They represent different classes of drug with differing side-effect profiles. OBJECTIVES To assess the comparative efficacy, safety and side-effects of long-acting beta-2 agonists and theophylline in the maintenance treatment of asthma. SEARCH STRATEGY Randomised, controlled trials (RCTs) were identified using the Cochrane Airways Group register. The register was searched using the following terms: asthma and theophylline and long acting beta-agonist or formoterol or foradile or eformoterol or salmeterol or bambuterol or Bitolterol. Date of last search was April 2003. Titles and abstracts were then screened to identify potentially relevant studies. The bibliography of each RCT was searched for additional RCTs. Authors of identified RCTs were contacted for other relevant published and unpublished studies. SELECTION CRITERIA All included studies were RCTs involving adults and children with clinical evidence of asthma. These studies must have compared oral sustained release and/or dose adjusted theophylline with an inhaled long-acting beta-2 agonist. DATA COLLECTION AND ANALYSIS Potentially relevant trials, identified by screening titles and/or abstracts, were obtained. Two reviewers independently assessed full text versions of these trials to decide whether the trial should be included in the review, and assessed its methodological quality. Where there was disagreement between reviewers, this was resolved by consensus, or reference to a third party. Data were extracted by two independent reviewers. Inter-rater reliability was assessed by simple agreement. Study authors were contacted to clarify randomisation methods, provide missing data, verify the data extracted and identify unpublished studies. Relevant pharmaceutical manufacturers were also contacted. MAIN RESULTS Six trials originally met the inclusion criteria. Five used salmeterol and one, Bitolterol. In an updated version of the review, six more trials were included. Four trials used salmeterol and two used formoterol. They were of varying quality. Salmeterol improved FEV1 significantly more than theophylline in five studies and salmeterol use was associated with significantly more symptom free nights in all the studies comparing these agents. Formoterol, used in two studies was reported to be as effective as theophylline. Bitolterol, used in only one study, was reported to be less effective than theophylline. Subjects taking salmeterol experienced fewer adverse events than those using theophylline (Parallel studies: Relative Risk 0.44; 95% CI: 0.30 to 0.63), Risk Difference -0.11 (95%CI: -0.16 to -0.07), NNT 9 (6, 14). Significant reductions were reported for central nervous system adverse events (Relative Risk 0.50; 95%Confidence Intervals 0.29, 0.86), Risk Difference -0.07(95% CI -0.12, -0.02), NNT 14(8, 50) and gastrointestinal adverse events (Relative Risk 0.30; 95%Confidence Intervals 0.17, 0.55), Risk Difference -0.11(-0.16, -0.06), NNT 9(6, 16). REVIEWER'S CONCLUSIONS Long-acting beta-2 agonists are at least as effective than theophylline in reducing asthma symptoms including night waking and improving lung function. Fewer adverse events occurred in subjects using long-acting beta-2 agonists(salmeterol and formoterol) as compared to theophylline.
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Long acting beta-agonists versus theophylline for maintenance treatment of asthma.
The Cochrane database of systematic reviews, 2000Co-Authors: A J Wilson, Peter G. Gibson, J CoughlanAbstract:Theophylline and long acting beta2-agonists are bronchodilators used for the management of persistent asthma symptoms, especially nocturnal asthma. They represent different classes of drug with differing side-effect profiles. To assess the comparative efficacy, safety and side-effects of long-acting beta-agonists and theophylline in the maintenance treatment of asthma. Randomised, controlled trials (RCTs) were identified using the Cochrane Airways Group register. The register was searched using the following terms: asthma and theophylline and long acting beta-agonist or formoterol or foradile or eformoterol or salmeterol or bambuterol or Bitolterol. Titles and abstracts were then screened to identify potentially relevant studies. The bibliography of each RCT was searched for additional RCTs. Authors of identified RCTs were contacted for other relevant published and unpublished studies. All included studies were RCTs involving adults and children with clinical evidence of asthma. These studies must have compared oral sustained release and/or dose adjusted theophylline with an inhaled long-acting beta-agonist. Potentially relevant trials, identified by screening titles and/or abstracts, were obtained. Two reviewers independently assessed full text versions of these trials to decided whether the trial should be included in the review, and assessed its methodological quality. Where there was disagreement between reviewers, this was resolved by consensus, or reference to a third party. Data were extracted by two independent reviewers. Inter-rater reliability was assessed by simple agreement. Study authors were contacted to clarify randomisation methods, provide missing data, verify the data extracted and identify unpublished studies. Relevant pharmaceutical manufacturers were also contacted. Six trials met the inclusion criteria. Five used salmeterol and one, biltoterol. They were of varying quality. There was a trend for salmeterol to improve FEV1 more than theophylline in three studies and salmeterol use was associated with more symptom free nights. Bitolterol, used in only one study, was reported to be less effective than theophylline. Subjects taking salmeterol experienced fewer adverse events than those using theophylline (Relative Risk 0.38; 95%Confidence Intervals 0.25, 0.57). Significant reductions were reported for central nervous system adverse events (Relative Risk 0.51; 95%Confidence Intervals 0.30, 0.88) and gastrointestinal adverse events (Relative Risk 0.32; 95%Confidence Intervals 0.17, 0.59). Salmeterol may be more effective than theophylline in reducing asthma symptoms including night waking and improving lung function. More adverse events occurred in subjects using theophylline when compared to salmeterol.
J Coughlan - One of the best experts on this subject based on the ideXlab platform.
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Long acting beta-agonists versus theophylline for maintenance treatment of asthma.
The Cochrane database of systematic reviews, 2000Co-Authors: A J Wilson, Peter G. Gibson, J CoughlanAbstract:Theophylline and long acting beta2-agonists are bronchodilators used for the management of persistent asthma symptoms, especially nocturnal asthma. They represent different classes of drug with differing side-effect profiles. To assess the comparative efficacy, safety and side-effects of long-acting beta-agonists and theophylline in the maintenance treatment of asthma. Randomised, controlled trials (RCTs) were identified using the Cochrane Airways Group register. The register was searched using the following terms: asthma and theophylline and long acting beta-agonist or formoterol or foradile or eformoterol or salmeterol or bambuterol or Bitolterol. Titles and abstracts were then screened to identify potentially relevant studies. The bibliography of each RCT was searched for additional RCTs. Authors of identified RCTs were contacted for other relevant published and unpublished studies. All included studies were RCTs involving adults and children with clinical evidence of asthma. These studies must have compared oral sustained release and/or dose adjusted theophylline with an inhaled long-acting beta-agonist. Potentially relevant trials, identified by screening titles and/or abstracts, were obtained. Two reviewers independently assessed full text versions of these trials to decided whether the trial should be included in the review, and assessed its methodological quality. Where there was disagreement between reviewers, this was resolved by consensus, or reference to a third party. Data were extracted by two independent reviewers. Inter-rater reliability was assessed by simple agreement. Study authors were contacted to clarify randomisation methods, provide missing data, verify the data extracted and identify unpublished studies. Relevant pharmaceutical manufacturers were also contacted. Six trials met the inclusion criteria. Five used salmeterol and one, biltoterol. They were of varying quality. There was a trend for salmeterol to improve FEV1 more than theophylline in three studies and salmeterol use was associated with more symptom free nights. Bitolterol, used in only one study, was reported to be less effective than theophylline. Subjects taking salmeterol experienced fewer adverse events than those using theophylline (Relative Risk 0.38; 95%Confidence Intervals 0.25, 0.57). Significant reductions were reported for central nervous system adverse events (Relative Risk 0.51; 95%Confidence Intervals 0.30, 0.88) and gastrointestinal adverse events (Relative Risk 0.32; 95%Confidence Intervals 0.17, 0.59). Salmeterol may be more effective than theophylline in reducing asthma symptoms including night waking and improving lung function. More adverse events occurred in subjects using theophylline when compared to salmeterol.
Louis B. Irving - One of the best experts on this subject based on the ideXlab platform.
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The Cochrane Library - Long-acting beta2-agonists versus theophylline for maintenance treatment of asthma.
The Cochrane database of systematic reviews, 2007Co-Authors: Augustine Tee, Mariko Siyue Koh, Peter G. Gibson, Toby J Lasserson, Amanda Wilson, Louis B. IrvingAbstract:BACKGROUND Theophylline and long acting beta-2 agonists are bronchodilators used for the management of persistent asthma symptoms, especially nocturnal asthma. They represent different classes of drug with differing side-effect profiles. OBJECTIVES To assess the comparative efficacy, safety and side-effects of long-acting beta-2 agonists and theophylline in the maintenance treatment of asthma. SEARCH STRATEGY Randomised, controlled trials (RCTs) were identified using the Cochrane Airways Group register. The register was searched using the following terms: asthma and theophylline and long acting beta-agonist or formoterol or foradile or eformoterol or salmeterol or bambuterol or Bitolterol. Date of last search was April 2003. Titles and abstracts were then screened to identify potentially relevant studies. The bibliography of each RCT was searched for additional RCTs. Authors of identified RCTs were contacted for other relevant published and unpublished studies. SELECTION CRITERIA All included studies were RCTs involving adults and children with clinical evidence of asthma. These studies must have compared oral sustained release and/or dose adjusted theophylline with an inhaled long-acting beta-2 agonist. DATA COLLECTION AND ANALYSIS Potentially relevant trials, identified by screening titles and/or abstracts, were obtained. Two reviewers independently assessed full text versions of these trials to decide whether the trial should be included in the review, and assessed its methodological quality. Where there was disagreement between reviewers, this was resolved by consensus, or reference to a third party. Data were extracted by two independent reviewers. Inter-rater reliability was assessed by simple agreement. Study authors were contacted to clarify randomisation methods, provide missing data, verify the data extracted and identify unpublished studies. Relevant pharmaceutical manufacturers were also contacted. MAIN RESULTS Six trials originally met the inclusion criteria. Five used salmeterol and one, Bitolterol. In an updated version of the review, six more trials were included. Four trials used salmeterol and two used formoterol. They were of varying quality. Salmeterol improved FEV1 significantly more than theophylline in five studies and salmeterol use was associated with significantly more symptom free nights in all the studies comparing these agents. Formoterol, used in two studies was reported to be as effective as theophylline. Bitolterol, used in only one study, was reported to be less effective than theophylline. Subjects taking salmeterol experienced fewer adverse events than those using theophylline (Parallel studies: Relative Risk 0.44; 95% CI: 0.30 to 0.63), Risk Difference -0.11 (95%CI: -0.16 to -0.07), NNT 9 (6, 14). Significant reductions were reported for central nervous system adverse events (Relative Risk 0.50; 95%Confidence Intervals 0.29, 0.86), Risk Difference -0.07(95% CI -0.12, -0.02), NNT 14(8, 50) and gastrointestinal adverse events (Relative Risk 0.30; 95%Confidence Intervals 0.17, 0.55), Risk Difference -0.11(-0.16, -0.06), NNT 9(6, 16). REVIEWER'S CONCLUSIONS Long-acting beta-2 agonists are at least as effective than theophylline in reducing asthma symptoms including night waking and improving lung function. Fewer adverse events occurred in subjects using long-acting beta-2 agonists(salmeterol and formoterol) as compared to theophylline.
M S Messina - One of the best experts on this subject based on the ideXlab platform.
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retrospective study of Bitolterol mesylate in the treatment of conditions associated with reversible bronchospasm
Advances in Therapy, 1995Co-Authors: M S MessinaAbstract:Patients with reversible bronchospasm benefit from the use of inhaled beta-adrenergic agents. In this retrospective study of 24 older patients with a variety of conditions associated with reversible bronchospasm--asthma, asthma with emphysema, chronic bronchitis, and asthmatic bronchitis--symptomatic improvement was noted after treatment with inhaled Bitolterol mesylate. Symptoms resolved or improved after 1 month in 93.8% (15/16) of patients using a metered-dose inhaler and in 75% (6/8) of those using a hand-held nebulizer. Sixteen additional patients were randomly selected to undergo pulmonary function tests after receiving two to three puffs of Bitolterol from a metered-dose inhaler. FEV1 improved by 10.9%, FVC by 12.1%, and FEF25%-75% by 34.4% after administration of Bitolterol. No adverse events were noted in any patients in either group. The results of this retrospective study suggest that Bitolterol is an effective and safe treatment in patients with conditions associated with reversible bronchospasm.