INTRODUCTION: About 10% of adults have suffered an attack of @entity565 , and up to 5% of these have severe disease that responds poorly to treatment. @entity1 with severe disease have an increased risk of @entity204 , but @entity1 with mild-to-moderate disease are also at risk of exacerbations. Most guidelines about the management of @entity565 follow stepwise protocols. This review does not endorse or follow any particular protocol, but presents the evidence about specific interventions. METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments for @entity102 ? What are the effects of treatments for @entity697 ? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2008 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). RESULTS: We found 99 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. CONCLUSIONS: In this systematic review, we present information relating to the effectiveness and safety of the following interventions. For @entity697 : @entity2263 agonists (plus @entity13265 , pressured metered-dose inhalers, short-acting continuous nebulised, short-acting intermittent nebulised, and short-acting intravenous); @entity288 (inhaled); @entity288 (single oral, combined inhaled, and short courses); education about @entity697 ; generalist care; helium- @entity26 mixture (heliox); @entity2400 (intravenous and adding isotonic nebulised @entity1760 to inhaled @entity2263 agonists); mechanical ventilation; @entity26 supplementation (controlled 28% @entity26 and controlled 100% @entity26 ); and specialist care. For @entity102 : @entity2263 agonists (adding long-acting inhaled @entity2263 agonists when @entity565 is poorly controlled by inhaled @entity288 , or short-acting inhaled @entity2263 agonists as needed for symptom relief); inhaled @entity288 (low dose and increasing dose); leukotriene antagonists (with or without inhaled @entity288 ); and @entity2544 (when poorly controlled by inhaled @entity288 ).

XXXX in adults.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity1760 :: ('MESH:D008274', 'Chemical') :: ['magnesium'] @entity2544 :: ('MESH:D013806', 'Chemical') :: ['theophylline'] @entity697 :: ('MESH:D000208', 'Disease') :: ['acute asthma'] @entity13265 :: ('MESH:D009241', 'Chemical') :: ['ipratropium bromide'] @entity565 :: ('MESH:D001249', 'Disease') :: ['asthma'] @entity26 :: ('MESH:D010100', 'Chemical') :: ['oxygen'] @entity102 :: ('MESH:D002908', 'Disease') :: ['chronic asthma'] @entity2400 :: ('CHEBI:32599', 'Chemical') :: ['magnesium sulphate'] @entity2263 :: ('10242', 'Gene') :: ['beta(2)'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death'] @entity288 :: ('MESH:D000305', 'Chemical') :: ['corticosteroids']
@entity565 :: (MESH:D001249,Disease) :: ['Asthma']
