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Guidelines Issued for Exercise-Induced Bronchoconstriction

WEDNESDAY, May 8 (HealthDay News) -- For patients with exercise-induced bronchoconstriction (EIB), use of a short-acting β2-agonist is strongly recommended before exercise, and further treatment with daily inhaled corticosteroid, a daily leukotriene receptor antagonist, or a mast cell stabilizing agent before exercise is recommended if necessary, according to guidelines published in the May 1 issue of the American Journal of Respiratory and Critical Care Medicine.

To provide practical guidance for physicians, Jonathan P. Parsons, M.D., and colleagues from the American Thoracic Society Subcommittee on Exercise-Induced Bronchoconstriction, reviewed the pathogenesis of EIB and developed evidence-based guidelines for its diagnosis and treatment. After appraisal of the evidence, recommendations were formulated using the Grading of Recommendations, Assessment, Development, and Evaluation approach.

The authors note that diagnosis of EIB should be established by exercise-induced changes in lung function rather than based on symptoms. For all patients with EIB, use of a short-acting β2-agonist before exercise is strongly recommended. For patients whose symptoms persist, treatment with a daily inhaled corticosteroid, a daily leukotriene receptor antagonist, or a mast cell stabilizing agent before exercise is strongly recommended.

"The recommendations in this guideline reflect the currently available evidence," the authors write. "New clinical research data will necessitate a revision and update in the future."

Several authors disclosed financial ties to the pharmaceutical and medical technology industries.

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