BACKGROUND: Exercise-induced bronchoconstriction (EIB) describes acute airway narrowing that occurs as a result of exercise. EIB occurs in a substantial proportion of patients with asthma, but may also occur in individuals without known asthma. METHODS: To provide clinicians with practical guidance, a multidisciplinary panel of stakeholders was convened to review the pathogenesis of EIB and to develop evidence-based guidelines for the diagnosis and treatment of EIB. The evidence was appraised and recommendations were formulated using the Grading of Recommendations, Assessment, Development, and Evaluation approach. RESULTS: Recommendations for the treatment of EIB were developed. The quality of evidence supporting the recommendations was variable, ranging from low to high. A strong recommendation was made for using a short-acting β(2)-agonist before exercise in all patients with EIB. For patients who continue to have symptoms of EIB despite the administration of a short-acting β(2)-agonist before exercise, strong recommendations were made for a daily inhaled corticosteroid, a daily leukotriene receptor antagonist, or a mast cell stabilizing agent before exercise. CONCLUSIONS: The recommendations in this Guideline reflect the currently available evidence. New clinical research data will necessitate a revision and update in the future.
BACKGROUND: Exercise-induced bronchoconstriction (EIB) describes acute airway narrowing that occurs as a result of exercise. EIB occurs in a substantial proportion of patients with asthma, but may also occur in individuals without known asthma. METHODS: To provide clinicians with practical guidance, a multidisciplinary panel of stakeholders was convened to review the pathogenesis of EIB and to develop evidence-based guidelines for the diagnosis and treatment of EIB. The evidence was appraised and recommendations were formulated using the Grading of Recommendations, Assessment, Development, and Evaluation approach. RESULTS: Recommendations for the treatment of EIB were developed. The quality of evidence supporting the recommendations was variable, ranging from low to high. A strong recommendation was made for using a short-acting β(2)-agonist before exercise in all patients with EIB. For patients who continue to have symptoms of EIB despite the administration of a short-acting β(2)-agonist before exercise, strong recommendations were made for a daily inhaled corticosteroid, a daily leukotriene receptor antagonist, or a mast cell stabilizing agent before exercise. CONCLUSIONS: The recommendations in this Guideline reflect the currently available evidence. New clinical research data will necessitate a revision and update in the future.
Authors: Mohamed S Al-Moamary; Sami A Alhaider; Abdullah A Alangari; Mohammed O Al Ghobain; Mohammed O Zeitouni; Majdy M Idrees; Abdullah F Alanazi; Adel S Al-Harbi; Abdullah A Yousef; Hassan S Alorainy; Mohamed S Al-Hajjaj Journal: Ann Thorac Med Date: 2019 Jan-Mar Impact factor: 2.219
Authors: Stephen E Kirkby; Don Hayes; Jonathan P Parsons; Clayton E Wisely; Ben Kopp; Karen S McCoy; John G Mastronarde Journal: Lung Date: 2015-06-03 Impact factor: 2.584
Authors: Nadia Spada Fiori; Anaclaudia Gastal Fassa; Neice Muller Xavier Faria; Rodrigo Dalke Meucci; Vanessa Iribarrem Miranda; David C Christiani Journal: Am J Ind Med Date: 2015-09-10 Impact factor: 2.214