Relief of dyspnoea by β2-agonists after methacholine-induced bronchoconstriction

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Virtually all asthma patients use bronchodilators. Formoterol and salbutamol have a rapid onset of bronchodilating effect, whereas salmeterol acts slower. We studied the onset of improvement of dyspnoea sensation after inhalation with these bronchodilators and placebo to reverse a methacholine-induced bronchoconstriction as a model for an acute asthma attack. Seventeen patients with asthma completed this randomised, double-blind, crossover, double-dummy study. On 4 test days, forced expiratory volume in 1 s (FEV1) and Borg score were recorded and patients were challenged with methacholine until FEV1 fell with ≥30% of baseline value. Thereafter, formoterol 12 μg via Turbuhaler®, salbutamol 50 μg via Turbuhaler®, salmeterol 50 μg via Diskhaler™, or placebo was inhaled. FEV1 and Borg scores were assessed during the following 60 min.The first sensed improvement of Borg score was significantly (P<0.05) faster achieved with formoterol (geometric mean (Gmean) (range) 1.5 (1-40) min) and salbutamol 1.8 (1-10) min than with salmeterol 4.5 (1-30) min and placebo 3.4 (1-40) min. The Borg score returned significantly faster to the baseline value with formoterol, salbutamol, and salmeterol (Gmean time 13.8 (1-75), 13.4 (1-60), and 18.0 (1-75) min, respectively) than with placebo (33.6 (1-75 min).Formoterol and salbutamol act significantly faster than salmeterol in relieving dyspnoea induced by methacholine-induced bronchoconstriction, in patients with asthma. © 2004 Elsevier Ltd. All rights reserved.




van der Woude, H. J., Postma, D. S., Politiek, M. J., Winter, T. H., & Aalbers, R. (2004). Relief of dyspnoea by β2-agonists after methacholine-induced bronchoconstriction. Respiratory Medicine, 98(9), 816–820.

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