Respiratory effect of beta-blocker eye drops in asthma: population-based study and meta-analysis of clinical trials
Respiratory effect of beta-blocker eye drops in asthma: population-based study and meta-analysis of clinical trials
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DOI：
10.1111/bcp.13006
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发表时间：
2016-09-01
影响因子：
3.4
通讯作者：
Guthrie, Bruce
中科院分区：
文献类型：
--
作者：
Morales, Daniel R.;Dreischulte, Tobias;Guthrie, Bruce
AimsTo measure the prevalence of beta-blocker eye drop prescription and respiratory effects of ocular beta-blocker administration in people with asthma.MethodsWe measured the prevalence of ocular beta-blocker prescription in people with asthma and ocular hypertension，并进行了一项巢式病例对照研究（NCCS），（初级保健中的补救类固醇）和严重急性发作（哮喘住院治疗），使用英国临床实践研究数据链的相关数据。然后，我们进行了系统的回顾和荟萃分析的临床试验评估肺功能的变化后，眼β受体阻滞剂管理的人与asthen.ResultsFrom 2000年至2012年，非选择性和选择性β受体阻滞剂滴眼液处方的人与哮喘和高眼压症的患病率分别从23.0%下降到13.4%和10.5%至0.9%。在NCCS中，中度急性加重的相对发生率（IRR）随着急性非选择性β受体阻滞剂滴眼液暴露而显著增加（IRR 4.83，95% CI 1.56-14.94），但随着慢性暴露而不显著增加。在荟萃分析中，急性非选择性β受体阻滞剂滴眼液暴露导致FEV 1显著平均福尔斯下降-10.9%（95% CI -14.9至-6.9），FEV 1福尔斯下降20%，影响三分之一。对眼部非选择性β受体阻滞剂敏感的人中选择性β受体阻滞剂的相应值为-6.3%（95% CI -11.7至-0.8），FEV 1的福尔斯下降20%，但无显著性增加。阻滞剂滴眼液显著影响肺功能并增加哮喘发病率，但尽管药物更安全，但仍经常用于哮喘和高眼压患者随时待命
AimsTo measure the prevalence of beta-blocker eye drop prescribing and respiratory effect of ocular beta-blocker administration in people with asthma.MethodsWe measured the prevalence of ocular beta-blocker prescribing in people with asthma and ocular hypertension, and performed a nested case-control study (NCCS) measuring risk of moderate exacerbations (rescue steroids in primary care) and severe exacerbations (asthma hospitalization) using linked data from the UK Clinical Practice Research Datalink. We then performed a systematic review and meta-analysis of clinical trials evaluating changes in lung function following ocular beta-blocker administration in people with asthma.ResultsFrom 2000 to 2012, the prevalence of non-selective and selective beta-blocker eye drop prescribing in people with asthma and ocular hypertension fell from 23.0% to 13.4% and from 10.5% to 0.9% respectively. In the NCCS, the relative incidence (IRR) of moderate exacerbations increased significantly with acute non-selective beta-blocker eye drop exposure (IRR 4.83, 95% CI 1.56-14.94) but not with chronic exposure. In the meta-analysis, acute non-selective beta-blocker eye drop exposure caused significant mean falls in FEV1 of -10.9% (95% CI -14.9 to -6.9), and falls in FEV1 of 20% affecting one in three. Corresponding values for selective beta-blockers in people sensitive to ocular non-selective beta-blockers was -6.3% (95% CI -11.7 to -0.8), and a non-significant increase in falls in FEV1 of 20%.ConclusionNon-selective beta-blocker eye drops significantly affect lung function and increase asthma morbidity but are still frequently prescribed to people with asthma and ocular hypertension despite safer agents being available.