Cardiff University | Prifysgol Caerdydd ORCA
Online Research @ Cardiff 
WelshClear Cookie - decide language by browser settings

Magnesium sulphate in acute severe asthma in children (MAGNETIC): a randomised, placebo-controlled trial

Powell, Colin Victor Eric, Kolamunnage-Dona, Ruwanthi, Lowe, John, Boland, Angela, Petrou, Stavros, Doull, Iolo John Manley, Hood, Kerenza and Williamson, Paula 2013. Magnesium sulphate in acute severe asthma in children (MAGNETIC): a randomised, placebo-controlled trial. The Lancet Respiratory Medicine 1 (4) , pp. 301-308. 10.1016/S2213-2600(13)70037-7

Full text not available from this repository.

Abstract

Background: Little evidence is available for the effect of nebulised magnesium sulphate (MgSO4) in acute asthma in children. We assessed the effect of MgSO4 treatment in children with severe acute asthma. Methods: In this randomised placebo-controlled, multi-centre, parallel trial, we enrolled children (aged 2–16 years) with severe acute asthma who did not respond to standard inhaled treatment from 30 hospitals in the UK. Children were randomly allocated (1:1) to receive nebulised salbutamol and ipratropium bromide with either 2·5 mL of isotonic MgSO4 (250 mmol/L; 151 mg per dose; MgSO4 group) or 2·5 mL of isotonic saline (placebo group) on three occasions at 20-min intervals. Randomisation was done with a computer-generated randomisation sequence, with random block sizes of two to four. Both patients and researchers were masked to treatment allocation. The primary outcome measure was the Yung Asthma Severity Score (ASS) at 60 min post-randomisation. We used a statistical significance level of p<0·05 for a between-group difference, but regarded a between-group difference in ASS of 0·5 as the minimal clinically significant treatment effect. Analysis was done by intention to treat. This trial is registered with controlled-trials.com, number ISRCTN81456894. Findings: Between Jan 3, 2009, and March 20, 2011, we recruited and randomly assigned 508 children to treatment: 252 to MgSO4 and 256 to placebo. Mean ASS at 60 min was lower in the MgSO4 group (4·72 [SD 1·37]) than it was in the placebo group (4·95 [SD 1·40]; adjusted difference −0·25, 95% CI −0·48 to −0·02; p=0·03). This difference, however, was not clinically significant. The clinical effect was larger in children with more severe asthma exacerbation (p=0·03) and those with symptoms present for less than 6 h (p=0·049). We detected no difference in the occurrence of adverse events between groups. Interpretation: Overall, nebulised isotonic MgSO4, given as an adjuvant to standard treatment, did not show a clinically significant improvement in mean ASS in children with acute severe asthma. However, the greatest clinical response was seen in children with more severe attacks (SaO2<92%) at presentation and those with preceding symptoms lasting less than 6 h.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Subjects: R Medicine > RJ Pediatrics
R Medicine > RM Therapeutics. Pharmacology
Additional Information: Written on on behalf of the MAGNETIC study group
Publisher: Elsevier
ISSN: 2213-2600
Funders: National Institute for Health Research Health Technology Assessment Programme
Last Modified: 13 Nov 2018 21:52
URI: http://orca-mwe.cf.ac.uk/id/eprint/48962

Citation Data

Cited 15 times in Google Scholar. View in Google Scholar

Cited 42 times in Scopus. View in Scopus. Powered By Scopus® Data

Actions (repository staff only)

Edit Item Edit Item