Findings

What do systematic reviews say?

93 questions · 97 findings · 36 reviews

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No studies found 4 · 4.1%GRADE not reported 4 · 4.1%Very low 18 · 18.6%Low 32 · 33%Moderate 30 · 30.9%High 9 · 9.3%

As‐required FABA/ICS inhalers vs regular inhaled steroid

Adverse events · mild asthma

As‐required FABA/ICS inhalers showed no clear difference in adverse events compared with regular inhaled steroid (moderate certainty).

1 finding from 1 review

Combination fixed‐dose beta agonist and steroid inhaler as required for adults or children with mild asthma 2021 · Cochrane Headline outcomes only
OR 0.96 [0.82, 1.14]
4 studies · 8072 participants
Moderate

Increased vs stable doses of inhaled corticosteroids

Serious adverse events 48 weeks · adults and children with chronic asthma

It is very uncertain whether increased changes serious adverse events 48 weeks compared with stable doses of inhaled corticosteroids (very low certainty).

1 finding from 1 review

Increased versus stable doses of inhaled corticosteroids for exacerbations of chronic asthma in adults and children 2022 · Cochrane Headline outcomes only
OR 1.69 [0.77, 3.71]
2 studies · 394 participants
Very low

Increased vs stable doses of inhaled corticosteroids

Non‐serious adverse events 43 weeks · adults and children with chronic asthma

It is very uncertain whether increased changes non‐serious adverse events 43 weeks compared with stable doses of inhaled corticosteroids (very low certainty).

1 finding from 1 review

Increased versus stable doses of inhaled corticosteroids for exacerbations of chronic asthma in adults and children 2022 · Cochrane Headline outcomes only
OR 2.15 [0.68, 6.73]
2 studies · 142 participants
Very low

Summary of findings: anti‐pseudomonal antibiotics vs placebo

Adverse events · adults and children with cystic fibrosis and a positive microbiological isolate of P aeruginosa from a respiratory tract specimen

1 finding from 1 review

Inhaled anti‐pseudomonal antibiotics for long‐term therapy in cystic fibrosis 2022 · Cochrane Headline outcomes only
no estimate extracted
6 studies · 1014 participants
Very low

School‐based ICS therapy vs home therapy

Adverse events · children with asthma

1 finding from 1 review

Interventions to improve adherence to inhaled steroids for asthma 2017 · Cochrane Headline outcomes only
no estimate extracted
1 study · 99 participants
GRADE not reported

Intermittent ICS vs placebo

Adverse events · Preschool children (<6 years)

Intermittent ICS showed no clear difference in adverse events compared with placebo (low certainty).

1 finding from 1 review

Intermittent inhaled corticosteroid therapy versus placebo for persistent asthma in children and adults 2015 · Cochrane Headline outcomes only
OR 0.86 [0.42, 1.75]
1 study · 166 participants
Low

Intermittent ICS vs placebo

Adverse events · School‐aged children and adults

Intermittent ICS showed no clear difference in adverse events compared with placebo (low certainty).

1 finding from 1 review

Intermittent inhaled corticosteroid therapy versus placebo for persistent asthma in children and adults 2015 · Cochrane Headline outcomes only
OR 2.9 [0.12, 71.96]
1 study · 243 participants
Low

Hypertonic saline vs Normal saline

Adverse events · people with bronchiectasis

Hypertonic saline showed no clear difference in adverse events compared with isotonic saline; GRADE not reported.

1 finding from 1 review

Inhaled hyperosmolar agents for bronchiectasis 2014 · Cochrane Headline outcomes only
OR 8.2 [0.4, 169.9]
1 study · 40 participants
GRADE not reported

LABA/LAMA vs LABA plus inhaled corticosteroid (ICS)

Number of participants experiencing any serious adverse events · stable COPD

Long‐acting muscarinic antagonist (LAMA) plus long‐acting… showed no clear difference in serious adverse events (number of people experiencing ≥ 1 SAEs) compared with LABA plus inhaled corticosteroid (ICS) (high certainty).

1 finding from 1 review

Long‐acting muscarinic antagonist (LAMA) plus long‐acting beta‐agonist (LABA) versus LABA plus inhaled corticosteroid… 2023 · Cochrane Headline outcomes only
OR 1.02 [0.91, 1.15]
18 studies · 23183 participants
High

Simplified vs usual regimens

All adverse events · people with asthma

Simplified showed no clear difference in all adverse events compared with usual regimens (low certainty).

1 finding from 1 review

Interventions to improve adherence to inhaled steroids for asthma 2017 · Cochrane Headline outcomes only
OR 0.76 [0.56, 1.04]
1 study · 1233 participants
Low

Stopping LABA vs continuing use of LABA+ICS

Adverse events (all) · adults with asthma well controlled on LABA and ICS

Stopping LABA showed no clear difference in adverse events (all) compared with continuing use of LABA+ICS (moderate certainty).

1 finding from 1 review

Stopping long‐acting beta₂‐agonists (LABA) for adults with asthma well controlled by LABA and inhaled corticosteroids 2015 · Cochrane Headline outcomes only
OR 0.83 [0.66, 1.05]
5 studies · 1339 participants
Moderate

LAMA add‐on vs long‐acting beta2‐agonists (LABA) add‐on

Adverse events (all) · adults with asthma not well controlled on ICS

Long‐acting muscarinic antagonists (LAMA) add‐on showed no clear difference in adverse events (all) compared with long‐acting beta2‐agonists (LABA) add‐on (moderate certainty).

1 finding from 1 review

Long‐acting muscarinic antagonists (LAMA) added to inhaled corticosteroids (ICS) versus addition of long‐acting… 2015 · Cochrane Headline outcomes only
OR 1.11 [0.92, 1.35]
3 studies · 1839 participants
Moderate

Combination of anticholinergics + beta2‐agonists vs B2‐agonists alone

Adverse health events · children hospitalised with an acute asthma exacerbation

1 finding from 1 review

Inhaled anticholinergics and short‐acting beta₂‐agonists versus short‐acting beta2‐agonists alone for children with… 2014 · Cochrane Headline outcomes only
no estimate extracted
2 studies · 290 participants
Moderate

Intervention not reported

Serious adverse events · children with chronic asthma

The intervention showed no clear difference in serious adverse events (moderate certainty).

1 finding from 1 review

Addition of long‐acting beta₂‐agonists to inhaled corticosteroids for chronic asthma in children 2015 · Cochrane Headline outcomes only
RR 1.54 [0.81, 2.94]
7 studies · 1343 participants
Moderate

Intervention not reported

Serious adverse events · children with chronic asthma

The intervention showed no clear difference in serious adverse events (moderate certainty).

1 finding from 1 review

Addition of long‐acting beta₂‐agonists to inhaled corticosteroids for chronic asthma in children 2015 · Cochrane Headline outcomes only
RR 1.17 [0.75, 1.85]
16 studies · 4022 participants
Moderate

Intermittent ICS vs placebo

Serious adverse events · School‐aged children and adults

Intermittent ICS showed no clear difference in serious adverse events compared with placebo (moderate certainty).

1 finding from 1 review

Intermittent inhaled corticosteroid therapy versus placebo for persistent asthma in children and adults 2015 · Cochrane Headline outcomes only
OR 1 [0.14, 7.25]
2 studies · 385 participants
Moderate

Intermittent ICS vs placebo

Serious adverse events · Preschool children (<6 years)

Intermittent ICS showed no clear difference in serious adverse events compared with placebo (low certainty).

1 finding from 1 review

Intermittent inhaled corticosteroid therapy versus placebo for persistent asthma in children and adults 2015 · Cochrane Headline outcomes only
OR 0.42 [0.17, 1.02]
3 studies · 439 participants
Low

LABA/ICS vs LTRA + ICS

Serious adverse events · patients with chronic asthma

LABA + ICS showed no clear difference in serious adverse events compared with LTRA + ICS (moderate certainty).

1 finding from 1 review

Addition to inhaled corticosteroids of long‐acting beta₂‐agonists versus anti‐leukotrienes for chronic asthma 2014 · Cochrane Headline outcomes only
RR 1.33 [0.99, 1.79]
9 studies · 6288 participants
Moderate

Intervention not reported

Any adverse events 49 weeks · adults with asthma

The intervention leads to lower any adverse events 49 weeks (high certainty).

1 finding from 1 review

Long‐acting muscarinic antagonists (LAMA) added to combination long‐acting beta₂‐agonists and inhaled corticosteroids… 2016 · Cochrane Headline outcomes only
OR 0.7 [0.52, 0.94]
3 studies · 1197 participants
High

LAMA add‐on vs ICS alone

Any adverse events 24 weeks · adults with asthma not well controlled on ICS

LAMA add‐on showed no clear difference in any adverse events 24 weeks compared with ICS alone (low certainty).

1 finding from 1 review

Long‐acting muscarinic antagonists (LAMA) added to inhaled corticosteroids (ICS) versus the same dose of ICS alone for… 2015 · Cochrane Headline outcomes only
OR 0.95 [0.8, 1.14]
5 studies · 2562 participants
Low