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

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Daniel Ramon Morales, Bruce Guthrie, Brian J. Lipworth, Peter T. Donnan, Catherine Miriam Jackson

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Background beta-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 beta-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 beta-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 beta-antagonist of which 441 (28.9%, 95% CI 26.7% to 31.2%) had active asthma and received a new beta-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 beta-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 beta-antagonist selectivity.

Conclusion These results suggest that prescribing new oral beta-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
Issue number6
Publication statusPublished - Jun 2011

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