Lack of efficacy of nebulized magnesium sulfate in treating adult asthma: A meta-analysis of randomized controlled trials.

Background Nebulized magnesium sulfate (MgSO 4 ) has been used to treat asthma, but the efficacy remains controversial. We aimed to comprehensively review the efficacy of nebulized MgSO 4 in treating adult patients with asthma. Methods PubMed, Embase, and Cochrane Library were searched for relevant studies published up to July 18, 2016. Randomized controlled trials (RCTs) were included if adult patients with acute or stable asthma had been treated with nebulized MgSO 4 compared with placebo or another bronchodilator. Standardized mean differences (SMDs), relative risks (RRs) and 95% confidence intervals (CIs) were calculated. Outcomes included pulmonary function, hospital admission and adverse events. Results A total of 1386 patients from sixteen trials (1240 acute asthma patients and 146 stable asthma patients) were subjected to meta-analysis. Compared to placebo as normal saline, whether using in acute or stable adult asthma, nebulized MgSO 4 did not significantly improve the respiratory function: SMD 0.39 (95% CI −0.03–0.82, P = 0.07), and 1.48 (95% CI −0.14–3.11, P = 0.07), respectively. Furthermore, nebulized MgSO 4 did not reduce hospital admission in adult patients with acute asthma (RR, 0.72; 95% CI, 0.52–1.00; P = 0.05), although it was not associated with increased adverse events (RR 1.15; 95% CI, 0.88–1.52; P = 0.31). Conclusions Evidence to date suggests that nebulized MgSO 4 has no role in the management of adult patients with acute or stable asthma. [ABSTRACT FROM AUTHOR]