A systematic review of magnesium sulfate for acute asthma in adults

doi:10.5246/jcps.2016.08.070

Abstract

Abstract:

In order to provide evidence for making clinical decision, the role of intravenous and nebulized MgSO₄ in treatment of adult’s acute asthma was systematically estimated in the present study. Pubmed, Embase, Web of Sciences, the Cochrane Library and two Chinese literature databases (CNKI, WanFang) were systematically searched up to January 2016. Randomized controlled trails (RCTs) that compared the clinical outcomes of MgSO₄ groups and placebo groups were included. The primary outcome was hospital admission. Secondary outcomes included pulmonary function, symptom scores, vital signs and adverse events. The methodological quality of the included studies was evaluated, and the forest plots with meta-analysis were drawn by RevMan 5.2. A total of 24 RCTs derived from 2931 patients were included. Both intravenous MgSO₄ and nebulized MgSO₄treatmentshad no effect upon hospital admission (RR 0.91, 95% CI 0.80 to 1.03, P = 0.14; RR 0.78, 95% CI 0.56 to 1.08, P = 0.14). Both intravenous MgSO₄ and nebulized MgSO₄treatmentswere associated with significant evidence upon respiratory function (SMD 0.23, 95% CI 0.03 to 0.43, P = 0.02; SMD 0.37, 95% CI 0.11 to 0.64, P = 0.006), but sensitivity analyses showed that outcomes were changed by omitting studies of less than 100 individuals (SMD 0.05, 95% CI -0.05 to 0.15, P = 0.35; SMD 0.05, 95% CI -0.16 to 0.25, P = 0.64). There were no statistically significant differences in clinical symptom scores and vital signs (heart or pulse rate; systolic blood pressure; respiratory rate) in either form of MgSO₄ compared with placebo groups (P>0.05). There were no serious adverse events reported in any literature. Overall, there was no role for intravenous and nebulized MgSO₄ in the management of acute asthma in adults. Considering the low risk of serious adverse effects and easy availability, it seemed reasonable to use intravenous or nebulized MgSO₄ treatment in adults with life threatening asthma in whom any potential benefit would justify the risks of treatment.

Key words: Magnesium sulphate, Adult asthma, Systematic review

CLC Number:

R954

Supporting:

Zhuo Ma, Xiangli Cui, Lihong Liu. A systematic review of magnesium sulfate for acute asthma in adults[J]. Journal of Chinese Pharmaceutical Sciences, 2016, 25(8): 621-631.

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