Magnesium Plus Albuterol More Effective Than Albuterol Alone in Asthma

October 21, 2002

Tinker Ready

Oct. 21, 2002 (Boston) — A combination of nebulized albuterol and magnesium is more effective than albuterol alone for children with mild to moderate asthma, according to a study presented at the American Academy of Pediatrics National Conference on Friday.

Some studies have indicated that intravenous magnesium sulfate combined with other bronchodilating agents can be beneficial to patients who arrive at the emergency department with severe acute asthma. However, less is known about nebulized magnesium. So far two studies have looked at the use of nebulized magnesium and albuterol in adults, said Prashant Mahajan, MD, of the Children's Hospital of Michigan in Detroit. "The studies have shown equivocal results," he said.

Dr. Mahajan's study, however, is the first to look at the effect of nebulized magnesium combined with albuterol in children.

Mahajan and his team designed a randomized, double-blinded study to compare two fast acting regimens in 62 patients who arrived at the Children's Hospital emergency department. Half of the group, aged 5 to 17 years, received a single dose of albuterol plus a dose of magnesium sulfate, while the control group received only albuterol. The doctors then measured the forced expiratory volume in one second (FEV1) in the two groups. At 20 minutes, the children who received magnesium combined with albuterol had a 15.5% improvement in lung function compared with an 8.4% increase in lung function in the children who received albuterol alone.

The results indicate that the addition of magnesium sulfate to albuterol is of benefit to young asthma patients, Dr. Maharani said. However, his study did not test whether the improved FEV1 will translate into improved outcomes for asthma patients. He and his team are now preparing a follow-up study, which will use hospitalization, rather than lung function, as a measure of the treatment's efficacy.

The results sound promising so far to Brian A. Smart, MD, an asthma specialist with the DuPage Medical Group in Glen Ellyn, Illinois, and a fellow of the American Academy of Allergy, Asthma and Immunology.

"It seems that magnesium sulfate added to beta2-agonists may be useful for sick patients who present in distress," he said.

However, he does not think there is enough evidence supporting the use of magnesium sulfate during routine office visits.

AAP National Conference: Abstract 29. Presented Oct. 18, 2002.

Reviewed by Gary D. Vogin, MD

Tinker Ready is a freelance writer for Medscape.

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