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Effectiveness and Safety of Nebulized Magnesium as Last Line Treatment in Adults with Acute Asthma Attack: A Systematic Review and Meta-Analysis

ACTA MEDICA INDONESIANA · Vol. 56 No. 1 (2024)

ISSN
2338-2732, 0125-9326
Published
2024-04-01
Publisher
The Indonesian Society of Internal Medicine
Language
eng

Abstract

Background: Asthma is a disease characterized by chronic airway inflammation, however one-third of asthmatic cases did not respond adequately. Inhaled magnesium has been proposed as a treatment for unresponsive asthma cases. However, its role remains controversial. This review evaluates the effectiveness and safety of nebulized magnesium compared to standard therapy (Beta Agonist, Anticholinergic, Corticosteroid) in adults with acute asthma attacks. Methods: The protocol has been registered in PROSPERO. A literature search was conducted through PubMed/MEDLINE, Cochrane, ProQuest, and Google Scholar, and using the keywords “inhaled magnesium” and “asthma”. Manual searches were carried out through data portals. Journal articles included are randomized controlled trials. The assessment risk of bias was performed using Version 2 of the Cochrane risk-of-bias tool for randomized trials. Results: There are five articles included in this review. There is no significant difference in readmission rate and oxygen saturation in the magnesium group compared to control (RR 1; 95% CI 0.92 to 1,08; p= 0,96 and MD 1,82; 95% CI -0.89 to 4.53; p= 0.19, respectively). There is a significant reduction of respiratory rate and clinical severity in magnesium (MD -1,72; 95% CI -3,1 to 0.35; p= 0.01, RR 0.29; 95% CI 0.17 to 0.69; p <0.001, respectively). There was a higher risk of side effects in the magnesium group (HR 1.56; 95%CI 1.05 to 2.32; p= 0.03). However, the side effects are relatively mild such as hypotension and nausea. Conclusion: Inhaled magnesium improves the outcome of asthmatic patients, especially in lung function, clinical severity, and respiratory rate. Moreover, inhaled magnesium is safe to be given.

Keywords

Collaboration network of the authors

40 authors · 314 co-authorship links · showing the 40 most connected

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  • National Research and Innovation Agency
  • University of Indonesia
  • Affiliation unknown
  • Different organisations
  • Same organisation
  • Affiliation unknown
  • Thicker line = more joint articles · bigger circle = more articles
Show as table
Co-authorOrganisationJoint articles
Edward FaisalAffiliation unknown19
Ikhwan RinaldiAffiliation unknown19
Siti SetiatiAffiliation unknown18
Alvina WidhaniAffiliation unknown14
Murdani AbdullahAffiliation unknown13
Kuntjoro HarimurtiAffiliation unknown12
Em YunirUniversity of Indonesia10
Eka GinanjarAffiliation unknown10
Imam SubektiAffiliation unknown9
Pringgodigdo NugrohoAffiliation unknown7
Idrus AlwiAffiliation unknown7
Khie Chen LieAffiliation unknown7
Evy YunihastutiAffiliation unknown7
Dadang MakmunAffiliation unknown6
Cosphiadi IrawanAffiliation unknown6
Dina ElitaAffiliation unknown6
Juferdy KurniawanAffiliation unknown6
Leonard NainggolanAffiliation unknown6
Muhadi MuhadiAffiliation unknown5
Anshari Saifuddin HasibuanAffiliation unknown5
Sukamto KoesnoeAffiliation unknown5
Rudy HidayatAffiliation unknown5
Andhika RachmanAffiliation unknown5
Robert SintoAffiliation unknown5
Irsan HasanAffiliation unknown5
Mira YuliantiNational Research and Innovation Agency4
Suzy MariaAffiliation unknown4
Adityo SusiloAffiliation unknown4
Agus Joko SusantoAffiliation unknown3
Dono AntonoAffiliation unknown3
Cleopas M RumendeAffiliation unknown3
Ika Prasetya WijayaAffiliation unknown3

Affiliations come from OpenAlex; journal OAI-PMH metadata carries none. Authors without an OpenAlex ID are matched by name, which can merge or split people.

Metadata source: OAI-PMH (metadata jurnal) http://www.actamedindones.org/index.php/ijim/oai, first harvested 8 Nov 2026, last seen 8 Nov 2026.
Original metadata (oai_dc) 
<oai_dc:dc xmlns="http://www.openarchives.org/OAI/2.0/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/  http://www.openarchives.org/OAI/2.0/oai_dc.xsd">
	<dc:title xml:lang="en-US">Effectiveness and Safety of Nebulized Magnesium  as Last Line Treatment in Adults with Acute Asthma Attack: A Systematic Review and Meta-Analysis</dc:title>
	<dc:creator>Darmawan, Danny</dc:creator>
	<dc:creator>Rengganis, Iris</dc:creator>
	<dc:creator>Rumende, Cleopas Martin</dc:creator>
	<dc:creator>Shatri, Hamzah</dc:creator>
	<dc:creator>Koesnoe, Soekamto</dc:creator>
	<dc:creator>Umbarawan, Yogi</dc:creator>
	<dc:creator>Putranto, Rudi</dc:creator>
	<dc:creator>Nasution, Sally Aman</dc:creator>
	<dc:subject xml:lang="en-US">Inhaled Magnesium</dc:subject>
	<dc:subject xml:lang="en-US">Asthma</dc:subject>
	<dc:subject xml:lang="en-US">Adult</dc:subject>
	<dc:subject xml:lang="en-US">asthma</dc:subject>
	<dc:description xml:lang="en-US">Background: Asthma is a disease characterized by chronic airway inflammation, however one-third of asthmatic cases did not respond adequately. Inhaled magnesium has been proposed as a treatment for unresponsive asthma cases. However, its role remains controversial. This review evaluates the effectiveness and safety of nebulized magnesium compared to standard therapy (Beta Agonist, Anticholinergic, Corticosteroid) in adults with acute asthma attacks. Methods: The protocol has been registered in PROSPERO. A literature search was conducted through PubMed/MEDLINE, Cochrane, ProQuest, and Google Scholar, and using the keywords “inhaled magnesium” and “asthma”. Manual searches were carried out through data portals. Journal articles included are randomized controlled trials. The assessment risk of bias was performed using Version 2 of the Cochrane risk-of-bias tool for randomized trials. Results: There are five articles included in this review. There is no significant difference in readmission rate and oxygen saturation in the magnesium group compared to control (RR 1; 95% CI 0.92 to 1,08; p= 0,96 and MD 1,82; 95% CI -0.89 to 4.53; p= 0.19, respectively). There is a significant reduction of respiratory rate and clinical severity in magnesium (MD -1,72; 95% CI -3,1 to 0.35; p= 0.01, RR 0.29; 95% CI 0.17 to 0.69; p &amp;lt;0.001, respectively). There was a higher risk of side effects in the magnesium group (HR 1.56; 95%CI 1.05 to 2.32; p= 0.03). However, the side effects are relatively mild such as hypotension and nausea. Conclusion: Inhaled magnesium improves the outcome of asthmatic patients, especially in lung function, clinical severity, and respiratory rate. Moreover, inhaled magnesium is safe to be given.</dc:description>
	<dc:publisher xml:lang="en-US">The Indonesian Society of Internal Medicine</dc:publisher>
	<dc:date>2024-04-01</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>http://www.actamedindones.org/index.php/ijim/article/view/2563</dc:identifier>
	<dc:source xml:lang="en-US">Acta Medica Indonesiana; Vol. 56 No. 1 (2024): Acta Medica Indonesiana; 3</dc:source>
	<dc:source>2338-2732</dc:source>
	<dc:source>0125-9326</dc:source>
	<dc:language>eng</dc:language>
	<dc:relation>http://www.actamedindones.org/index.php/ijim/article/view/2563/pdf</dc:relation>
	<dc:rights xml:lang="en-US">Copyright (c) 2024 Danny Darmawan</dc:rights>
</oai_dc:dc>