The Lancet Respiratory Medicine: Radiological correlates and clinical implications of the paradoxical lung function response to β2 agonists

Paradoxical bronchoconstriction in response to the use of bronchodilators is not well understood. This study is the first to investigate the prevalence of bronchoconstriction after using bronchodilators, such as β2 agonists, in 9986 smokers and ex-smokers with COPD. A paradoxical response was twice as common in African-American patients, and was also associated with worse respiratory outcomes including more shortness of breath, shorter 6 minute walk distance, and more frequent exacerbations. The authors conclude that their findings may have implications for the use of β2 agonists in a subset of patients.