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Regular treatment with long acting beta agonists versus daily regular treatment with short acting beta agonists in adults and children with stable asthma

Overview of attention for article published in Cochrane database of systematic reviews, July 2002
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Regular treatment with long acting beta agonists versus daily regular treatment with short acting beta agonists in adults and children with stable asthma
Published in
Cochrane database of systematic reviews, July 2002
DOI 10.1002/14651858.cd003901
Pubmed ID

E. Haydn Walters, Julia AE Walters, Peter G Gibson


Selective beta-adrenergic agonists for use in asthma are: short acting (2-6 hours) and long acting (>12 hours). There has been little controversy about using short acting beta-agonists intermittently, but long acting beta-agonists are used regularly, and their regular use has been controversial. To determine the benefit or detriment of treatment with regular short- or long acting inhaled beta-agonists in chronic asthma. A search was carried out using the Cochrane Airways Group register. Bibliographies of identified RCTs were searched for additional relevant RCTs. Authors of identified RCTs were contacted for other published and unpublished studies. All randomised studies of at least two weeks duration, comparing a long acting inhaled beta-agonist given twice daily with any short acting inhaled beta-agonist of equivalent bronchodilator effectiveness given regularly in chronic asthma. Two reviewers performed data extraction and study quality assessment independently. Authors of studies were contacted for missing data. 31 studies met the inclusion criteria, 24 of parallel group and 7 cross over design. Salmeterol xinafoate was used as long acting agent in 22 studies and formoterol fumarate in 9. Salbutamol was the short acting agent used in 27 studies and terbutaline in 5. The treatment period was over 2 weeks in 29 studies, and at least 12 weeks in 20. 25 studies permitted a variety of co-intervention treatments, usually inhaled corticosteroid or cromones. One study did not permit inhaled corticosteroid. Long acting beta-agonists were significantly better than short acting for a variety of lung function measurements including morning PEF (Weighted Mean Difference (WMD) 33 l/min 95% CI 25, 42) or evening PEF (WMD 26 l/min 95% CI 18, 33); and had significantly lower scores for day and night time asthma symptom scores and percentage of days and nights without symptoms. They were also associated with a significantly lower use of rescue medication both during the day and night. Risk of exacerbations was not different between the two types of agent, but most studies were of short duration which limits the power to test for such differences. Long acting inhaled beta-agonists have advantages across a wide range of physiological and clinical outcomes for regular treatment.

Mendeley readers

The data shown below were compiled from readership statistics for 49 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 2%
United States 1 2%
Unknown 47 96%

Demographic breakdown

Readers by professional status Count As %
Student > Master 11 22%
Student > Ph. D. Student 8 16%
Student > Bachelor 8 16%
Researcher 5 10%
Student > Doctoral Student 4 8%
Other 8 16%
Unknown 5 10%
Readers by discipline Count As %
Medicine and Dentistry 26 53%
Nursing and Health Professions 6 12%
Social Sciences 2 4%
Neuroscience 2 4%
Agricultural and Biological Sciences 1 2%
Other 5 10%
Unknown 7 14%