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Concerns with beta2-agonists in pediatric asthma - a clinical perspective

Kersten, E. T. G., Koppelman, G. H. & Thio, B. J., Jan-2017, In : Paediatric respiratory reviews. 21, p. 80-85 6 p.

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  • Concerns with beta2-agonists in pediatric asthma - a clinical perspective

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Beta2-adrenoreceptor agonists (beta 2-agonists) are extensively used in the treatment of childhood asthma. However, there have been concerns regarding their adverse effects and safety. In 2005, the FDA commissioned a "Black Box Warning" communicating the potential for an increased risk for serious asthma exacerbations or asthma related deaths, with the regular use of LABAs. In a meta-analysis of controlled clinical trials, the incidence of severe adverse events appeared to be highest in the 4-11 year age group. Several mechanisms have been proposed regarding the risk of regular use of beta 2-agonists, such as masking patients' perception of worsening asthma, desensitization and downregulation of the beta 2-adrenoreceptor, pro-inflammatory effects of beta 2-agonists, pharmacogenetic effects of beta 2-adrenoreceptor polymorphisms and age related differences in pathophysiology of asthma.

In this paper, we review beta 2-receptor pharmacology, discuss the concerns regarding treatment with beta 2-agonists in childhood asthma, and provide suggestions for clinical pediatric practice in the light of current literature. (C) 2016 Elsevier Ltd. All rights reserved.

Original languageEnglish
Pages (from-to)80-85
Number of pages6
JournalPaediatric respiratory reviews
Volume21
Early online date16-Jun-2016
Publication statusPublished - Jan-2017

    Keywords

  • beta 2-agonists, Tolerance, Asthma, Genetic polymorphisms, LONG-ACTING BETA(2)-AGONISTS, AIRWAY SMOOTH-MUSCLE, AGE-RELATED-CHANGES, BETA-AGONISTS, UNITED-STATES, SALMETEROL, FORMOTEROL, CHILDREN, THERAPY, POLYMORPHISM

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