What do systematic reviews say?

Inhaled corticosteroids vs systemic corticosteroids

ICS showed no clear difference in hospital admission compared with systemic corticosteroids (low certainty).

• Early use of inhaled corticosteroids in the emergency department treatment of acute asthma 2012 · Cochrane Headline outcomes only
  OR 0.56 [0.25, 1.24]
  10 studies · 763 participants
  Low

Inhaled corticosteroids vs placebo

ICS may leads to lower hospital admission compared with placebo (low certainty).

• Early use of inhaled corticosteroids in the emergency department treatment of acute asthma 2012 · Cochrane Headline outcomes only
  OR 0.44 [0.31, 0.61]
  12 studies · 959 participants
  Low

Any ICS vs oral corticosteroid

Any ICS showed no clear difference in hospital admission compared with oral corticosteroid (moderate certainty).

• Inhaled steroids for acute asthma following emergency department discharge 2012 · Cochrane Headline outcomes only
  OR 0.31 [0.01, 7.95]
  3 studies · 254 participants
  Moderate

Any ICS plus oral corticosteroid vs oral corticosteroid

Any ICS plus oral corticosteroid showed no clear difference in hospital admission compared with oral corticosteroid (moderate certainty).

• Inhaled steroids for acute asthma following emergency department discharge 2012 · Cochrane Headline outcomes only
  OR 0.99 [0.39, 2.52]
  2 studies · 805 participants
  Moderate

Once‐daily ICS/LABA combined inhalers vs once‐daily LAMA

It is very uncertain whether once‐daily ICS/LABA combined inhalers changes hospital admissions (all‐cause) compared with once‐daily LAMA (very low certainty).

• Once‐daily long‐acting beta₂‐agonists/inhaled corticosteroids combined inhalers versus inhaled long‐acting muscarinic… 2018 · Cochrane Headline outcomes only
  OR 0.96 [0.49, 1.89]
  2 studies · 880 participants
  Very low

Anti‐leukotrienes & ICS vs same‐dose ICS

• Addition of anti‐leukotriene agents to inhaled corticosteroids in children with persistent asthma 2013 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 279 participants
  Very low

Anti‐leukotrienes & ICS vs ICS dose increase

Anti‐leukotrienes & ICS may leads to higher participants with exacerbations requiring hospital admission compared with higher dose ICS (low certainty).

• Addition of anti‐leukotriene agents to inhaled corticosteroids in children with persistent asthma 2013 · Cochrane Headline outcomes only
  Risk Ratio 1
  1 study · 182 participants
  Low