March 10, 2014
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Asthma relapse more likely after use of short-acting beta-2 agonists

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Children who took short-acting beta-2 agonists within 6 hours before hospital admission and the presence of retractions on physical examinations increased their risk for relapse after the treatment for asthma exacerbations, according to data.

“In patients who are discharged from an emergency department after an asthma attack, those who took short-acting beta-2 agonists before admissions should be followed up closely because of the possibility of relapse,” researchers wrote.

Erdem Topal, MD, of the department of pediatric allergy and asthma at the Gazi University in Ankara, Turkey, and colleagues conducted the multicenter, prospective study of children with asthma attacks (n=1,177; aged 6 months to 17 years) with a mean age of 70.72 months.

Within 1 week after hospital discharge, 199 (16.9%) patients relapsed, according to researchers.

“In our study, use of accessory respiratory muscles at admission increased the relapse rate by 1.76-fold,” they wrote.

Logistic regression models allowed for the identification of factors that were independently associated with relapse, including: having taken a short-acting inhaled beta-2 agonist within 6 hours before admission (OR=2.43; 95% CI, 1.728-3.426); the presence of retraction on physical examination (OR=1.76; 95% CI, 1.123-2.774); no prescription for high-dose inhaled steroids on release (OR=2.02; 95% CI, 1.37-3.002); and not being given a written instructional plan (OR=1.55; 95% CI, 1.08-2.226), according to data.

The researchers said their results could not be generalized because of study limitations, including a lack of other environmental factors being considered and a limited number of patients from various areas. Patients who have taken short-acting beta-2 agonists before hospitalization should be followed-up due to the risk for relapse, they concluded.

Disclosure: The researchers report no relevant financial disclosures.