Magnesium sulfate treatment for acute severe asthma in adults—a systematic review and meta-analysis
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Magnesium sulfate treatment for acute severe asthma in adults—a systematic review and meta-analysis. / Rovsing, Alma Holm; Savran, Osman; Ulrik, Charlotte Suppli.
In: Frontiers in allergy, Vol. 4, 1211949, 2023.Research output: Contribution to journal › Review › Research › peer-review
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TY - JOUR
T1 - Magnesium sulfate treatment for acute severe asthma in adults—a systematic review and meta-analysis
AU - Rovsing, Alma Holm
AU - Savran, Osman
AU - Ulrik, Charlotte Suppli
N1 - Publisher Copyright: 2023 Rovsing, Savran and Ulrik.
PY - 2023
Y1 - 2023
N2 - Introduction: Add-on magnesium sulfate (MgSO4) for refractory asthma exacerbation has been much debated. The aim of this review and meta-analysis is, therefore, to provide an update on the current evidence for the efficacy of MgSO4 in exacerbations of asthma in adults refractory to standard of care treatment. Methods: A systematic review was performed in accordance with the PRISMA guidelines. The search was performed in the PubMed database (updated April 2023). For the meta-analysis, a random-effects model was applied using the metaphor package for RStudio (RStudio, Inc.). Results: A total of 17 randomized controlled trials were included. Three of the nine studies addressing treatment with intravenous (IV) MgSO4 found a significant effect on lung function compared to placebo. Of the eight studies investigating hospital admission rate, only two found a significant effect of MgSO4. Six of the nine studies investigating treatment with nebulized MgSO4 compared to placebo found a favorable effect on forced expiratory volume in 1. second (FEV1) and peak expiratory flow rate (PEF). Only two of the five studies investigating the effect on hospital admission rate found an effect of MgSO4. Comparing effect sizes in a meta-analysis revealed a greater effect on PEF in asthma patients treated with nebulized MgSO4 (MD, 23.57; 95% CI, −2.48 to 49.62, p < 0.01) compared to placebo. The analysis of patients treated with i.v. MgSO4 compared to placebo showed no statistically significant difference (MD, 5.49; 95% CI, −18.67 to 29.65, p = 0.10). Conclusion: Up to two out of three studies revealed an effect of MgSO4 treatment for asthma exacerbation when assessed by FEV1/PEF, but fewer studies were positive for the outcome of hospital admissions.
AB - Introduction: Add-on magnesium sulfate (MgSO4) for refractory asthma exacerbation has been much debated. The aim of this review and meta-analysis is, therefore, to provide an update on the current evidence for the efficacy of MgSO4 in exacerbations of asthma in adults refractory to standard of care treatment. Methods: A systematic review was performed in accordance with the PRISMA guidelines. The search was performed in the PubMed database (updated April 2023). For the meta-analysis, a random-effects model was applied using the metaphor package for RStudio (RStudio, Inc.). Results: A total of 17 randomized controlled trials were included. Three of the nine studies addressing treatment with intravenous (IV) MgSO4 found a significant effect on lung function compared to placebo. Of the eight studies investigating hospital admission rate, only two found a significant effect of MgSO4. Six of the nine studies investigating treatment with nebulized MgSO4 compared to placebo found a favorable effect on forced expiratory volume in 1. second (FEV1) and peak expiratory flow rate (PEF). Only two of the five studies investigating the effect on hospital admission rate found an effect of MgSO4. Comparing effect sizes in a meta-analysis revealed a greater effect on PEF in asthma patients treated with nebulized MgSO4 (MD, 23.57; 95% CI, −2.48 to 49.62, p < 0.01) compared to placebo. The analysis of patients treated with i.v. MgSO4 compared to placebo showed no statistically significant difference (MD, 5.49; 95% CI, −18.67 to 29.65, p = 0.10). Conclusion: Up to two out of three studies revealed an effect of MgSO4 treatment for asthma exacerbation when assessed by FEV1/PEF, but fewer studies were positive for the outcome of hospital admissions.
KW - acute asthma
KW - FEV
KW - intravenous
KW - meta-analysis
KW - MgSO4
KW - nebulized
KW - PEF
KW - systematic review
U2 - 10.3389/falgy.2023.1211949
DO - 10.3389/falgy.2023.1211949
M3 - Review
C2 - 37577333
AN - SCOPUS:85167909023
VL - 4
JO - Frontiers in allergy
JF - Frontiers in allergy
SN - 2673-6101
M1 - 1211949
ER -
ID: 370582282