Findings

What do systematic reviews say?

39 questions · 39 findings · 19 reviews · Airways

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No studies found 1 · 2.6%GRADE not reported 1 · 2.6%Very low 6 · 15.4%Low 12 · 30.8%Moderate 14 · 35.9%High 5 · 12.8%

Intramuscular corticosteroids vs oral corticosteroid

Adverse events · patients with acute asthma

Intramuscular corticosteroids showed no clear difference in adverse events compared with oral corticosteroids (low certainty).

1 finding from 1 review

Intramuscular versus oral corticosteroids to reduce relapses following discharge from the emergency department for… 2018 · Cochrane Headline outcomes only
RR 0.83 [0.64, 1.07]
5 studies · 404 participants
Low

Inhaled corticosteroids plus standard care vs placebo or usual care

Adverse events · adults with a confirmed diagnosis of mild COVID‐19, of whom only 10% (219/2132) participants had received ≥ 1 vaccination

Inhaled corticosteroids plus standard care showed no clear difference in adverse events compared with standard care (with or without placebo) (low certainty).

1 finding from 1 review

Inhaled corticosteroids for the treatment of COVID‐19 2022 · Cochrane Headline outcomes only
RR 0.78 [0.47, 1.31]
1 study · 400 participants
Low

Inhaled corticosteroids plus standard care vs placebo or usual care

Serious adverse events · adults with a confirmed diagnosis of mild COVID‐19, of whom only 10% (219/2132) participants had received ≥ 1 vaccination

It is very uncertain whether inhaled corticosteroids plus standard care changes serious adverse events compared with standard care (with or without placebo) (very low certainty).

1 finding from 1 review

Inhaled corticosteroids for the treatment of COVID‐19 2022 · Cochrane Headline outcomes only
RR 0.51 [0.09, 2.76]
1 study · 1586 participants
Very low

A boost of inhaled corticosteroids vs usual care

Adverse events · autumn asthma exacerbations in children

A boost of inhaled corticosteroids showed no clear difference in adverse events compared with usual care (moderate certainty).

1 finding from 1 review

Interventions for autumn exacerbations of asthma in children 2018 · Cochrane Headline outcomes only
OR 0.67 [0.34, 1.33]
1 study · 176 participants
Moderate

Corticosteroids vs placebo

Number of participants experiencing any serious adverse events · Children with obstructive sleep apnoea (aged 15 years or younger)

The review found no eligible studies for this question.

1 finding from 1 review

Anti‐inflammatory medications for obstructive sleep apnoea in children 2020 · Cochrane Headline outcomes only
no estimate extracted
Studies not reported
No studies found

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

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

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

Antibiotics vs placebo

Serious adverse events WMD of · Adults (aged 40 or over) with COPD presenting with 1 or more exacerbations in the previous year. The 2 larger studies (Albert 2011; Sethi…

Antibiotics showed no clear difference in serious adverse events WMD of compared with placebo (moderate certainty).

1 finding from 1 review

Prophylactic antibiotic therapy for chronic obstructive pulmonary disease (COPD) 2018 · Cochrane Headline outcomes only
OR 0.88 [0.74, 1.05]
9 studies · 2978 participants
Moderate

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

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

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

Intervention not reported

Total number of adverse events · children with chronic asthma

The intervention showed no clear difference in total number of adverse events (high 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 1.01 [0.92, 1.1]
6 studies · 1254 participants
High

Intervention not reported

Total number of adverse events · children with chronic asthma

The intervention showed no clear difference in total number of 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 1.04 [0.98, 1.1]
15 studies · 3284 participants
Moderate

Intervention not reported

Serious adverse events 49 weeks · adults with asthma

The intervention showed no clear difference in serious adverse events 49 weeks (low 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 0.6 [0.24, 1.47]
3 studies · 1197 participants
Low