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Background <p>Asthma is a prevalent inflammatory airway condition characterized by reversible airflow obstruction. It poses significant health risks, especially during acute exacerbations, which can be potentially fatal if untreated. This study aims to review the safety and efficacy of terbutaline in comparison to epinephrine in treating acute pediatric asthma exacerbations in emergency settings.</p> Methods <p>This systematic review was conducted following the PRISMA guidelines. A comprehensive literature search was performed across PubMed, MEDLINE, EMBASE, and the Cochrane Library up to December 2023. We included randomized controlled trials (RCTs) comparing the safety and efficacy of terbutaline to epinephrine in asthma exacerbation in Children aged 21 years and below in the ED. Outcomes assessed for efficacy were Forced Expiratory Volume in one second (FEV1), Forced Vital Capacity (FVC), and Peak Expiratory Flow Rate (PEF). For safety, outcomes included incidence of adverse events including Tachycardia, arrhythmias, and blood pressure changes.</p> Results <p>Ten randomized controlled trials (RCTs) involving 510 children were included. The studies showed that both terbutaline and epinephrine significantly improved respiratory parameters, with no significant difference in adverse events. Terbutaline showed an advantage in FEV1 and FVC. Cardiovascular effects were more favorable with terbutaline, with lower increases in heart rate and blood pressure.</p> Conclusions <p>Terbutaline and epinephrine are effective and safe for treating acute pediatric asthma exacerbations. Terbutaline’s slightly better efficacy in certain respiratory parameters and favorable cardiovascular profile suggest it may be preferable in specific clinical scenarios. Further research is warranted to confirm these findings and optimize treatment protocols. PROSPERO registration (CRD42023485496).</p>

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Efficacy and Safety of Terbutaline vs. Epinephrine for Treating Pediatric Asthma in Emergency: A Systematic Review of Randomized Controlled Trials

  • 期刊论文

  • 发表日期：

    2025年1月27日

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  • Mohammed Alsabri,
  • Mohamed Mabrouk Ghonaim,
  • Alaa Ahmed Elshanbary,
  • Shrouk Ramadan,
  • Amira A. Aboali,
  • Arham Iqbal,
  • Luis L. Gamboa,
  • Salma Tamer Abdelrahman,
  • Isma Butt

摘要

Background

Asthma is a prevalent inflammatory airway condition characterized by reversible airflow obstruction. It poses significant health risks, especially during acute exacerbations, which can be potentially fatal if untreated. This study aims to review the safety and efficacy of terbutaline in comparison to epinephrine in treating acute pediatric asthma exacerbations in emergency settings.

Methods

This systematic review was conducted following the PRISMA guidelines. A comprehensive literature search was performed across PubMed, MEDLINE, EMBASE, and the Cochrane Library up to December 2023. We included randomized controlled trials (RCTs) comparing the safety and efficacy of terbutaline to epinephrine in asthma exacerbation in Children aged 21 years and below in the ED. Outcomes assessed for efficacy were Forced Expiratory Volume in one second (FEV1), Forced Vital Capacity (FVC), and Peak Expiratory Flow Rate (PEF). For safety, outcomes included incidence of adverse events including Tachycardia, arrhythmias, and blood pressure changes.

Results

Ten randomized controlled trials (RCTs) involving 510 children were included. The studies showed that both terbutaline and epinephrine significantly improved respiratory parameters, with no significant difference in adverse events. Terbutaline showed an advantage in FEV1 and FVC. Cardiovascular effects were more favorable with terbutaline, with lower increases in heart rate and blood pressure.

Conclusions

Terbutaline and epinephrine are effective and safe for treating acute pediatric asthma exacerbations. Terbutaline’s slightly better efficacy in certain respiratory parameters and favorable cardiovascular profile suggest it may be preferable in specific clinical scenarios. Further research is warranted to confirm these findings and optimize treatment protocols. PROSPERO registration (CRD42023485496).