Effectiveness of inhaled furosemide for acute asthma exacerbation: a meta-analysis

As the effectiveness of beta-agonists for treating asthma attacks has been established, numerous other supportive treatments for asthma attacks have also been investigated, such as systemic glucocorticoids and magnesium. Among these additional therapies, inhaled furosemide is of particular interest; several studies have evaluated the effects of prophylactic inhaled furosemide in attenuating bronchoconstriction and asthma attacks. To determine the efficacy of inhaled furosemide during asthma attacks, we performed a systematic review using the MEDLINE, EMBASE, Web of Science, and Cochrane Library databases from their inception through 14 March 2014. A meta-analysis was conducted by calculating the standardized mean difference from each study and integrating these means using a random effects model. In addition, subanalyses were performed in the studies that evaluated the peak expiratory flow rate and the forced expiratory volume in 1 second. We identified six studies using double-blinded, randomized control trial designs that evaluated inhaled furosemide in conjunction with standard treatments in patients experiencing asthma attacks [1-6] (Figure 1); a total of 78 patients received inhaled furosemide and 79 patients received a placebo (Tables 1 and 2). The mean age of patients ranged from 8.4 to 47 years [3,6]. In two studies, patients were administered 40 mg inhaled