What do systematic reviews say?

Budesonide/formoterol (BDF) vs placebo

Budesonide/formoterol (BDF) showed no clear difference in adverse events—'serious'—320/94 Duration of 10 months3 compared with placebo (low certainty).

• Combined corticosteroid and long‐acting beta₂‐agonist in one inhaler versus placebo for chronic obstructive pulmonary… 2013 · Cochrane Headline outcomes only
  OR 1.17 [0.95, 1.45]
  2476 participants
  Low

Budesonide/formoterol (BDF) vs placebo

Budesonide/formoterol (BDF) showed no clear difference in adverse events—'serious'—160/94 Duration of nine months 3 compared with placebo (low certainty).

• Combined corticosteroid and long‐acting beta₂‐agonist in one inhaler versus placebo for chronic obstructive pulmonary… 2013 · Cochrane Headline outcomes only
  OR 1.2 [0.89, 1.63]
  1556 participants
  Low

Mometasone/formoterol (MF/F) vs placebo

Mometasone/formoterol (MF/F) showed no clear difference in adverse event—any—400/103 Duration of six months compared with placebo (low certainty).

• Combined corticosteroid and long‐acting beta₂‐agonist in one inhaler versus placebo for chronic obstructive pulmonary… 2013 · Cochrane Headline outcomes only
  OR 0.98 [0.75, 1.3]
  890 participants
  Low
• Combined corticosteroid and long‐acting beta₂‐agonist in one inhaler versus placebo for chronic obstructive pulmonary… 2013 · Cochrane Headline outcomes only
  OR 0.82 [0.62, 1.09]
  894 participants
  Low

Mometasone/formoterol (MF/F) vs placebo

Mometasone/formoterol (MF/F) showed no clear difference in adverse events—serious—400/103 Duration of six months compared with placebo (low certainty).

• Combined corticosteroid and long‐acting beta₂‐agonist in one inhaler versus placebo for chronic obstructive pulmonary… 2013 · Cochrane Headline outcomes only
  OR 1.09 [0.66, 1.79]
  890 participants
  Low

Mometasone/formoterol (MF/F) vs placebo

Mometasone/formoterol (MF/F) showed no clear difference in adverse events—serious—200/103 Duration of six months compared with placebo (low certainty).

• Combined corticosteroid and long‐acting beta₂‐agonist in one inhaler versus placebo for chronic obstructive pulmonary… 2013 · Cochrane Headline outcomes only
  OR 0.71 [0.41, 1.23]
  894 participants
  Low

Combined inhalers vs placebo (outcomes

Combined inhalers probably leads to lower participants with at least one exacerbation Duration of six months3 compared with placebo (primary outcomes) (moderate certainty).

• Combined corticosteroid and long‐acting beta₂‐agonist in one inhaler versus placebo for chronic obstructive pulmonary… 2013 · Cochrane Headline outcomes only
  OR 0.78 [0.66, 0.93]
  3141 participants
  Moderate

Combined inhalers vs placebo (outcomes

Combined inhalers probably leads to lower mortality Duration of 18 months3 compared with placebo (primary outcomes) (moderate certainty).

• Combined corticosteroid and long‐acting beta₂‐agonist in one inhaler versus placebo for chronic obstructive pulmonary… 2013 · Cochrane Headline outcomes only
  OR 0.82 [0.68, 0.99]
  16 studies · 10129 participants
  Moderate

Combined inhalers vs placebo (outcomes

Combined inhalers probably leads to higher pneumonia Duration of 18 months3 compared with placebo (primary outcomes) (moderate certainty).

• Combined corticosteroid and long‐acting beta₂‐agonist in one inhaler versus placebo for chronic obstructive pulmonary… 2013 · Cochrane Headline outcomes only
  OR 1.62 [1.36, 1.94]
  14 studies · 9620 participants
  Moderate

Combined inhalers vs placebo (outcomes

Combined inhalers showed no clear difference in hospitalisations due to COPD exacerbations Duration of 18 months3 compared with placebo (primary outcomes) (low certainty).

• Combined corticosteroid and long‐acting beta₂‐agonist in one inhaler versus placebo for chronic obstructive pulmonary… 2013 · Cochrane Headline outcomes only
  OR 0.93 [0.81, 1.06]
  12 studies · 9492 participants
  Low

Combination fluticasone/salmeterol vs placebo

Fluticasone/salmeterol (FPS) showed no clear difference in adverse events—any Duration of two years1 compared with placebo (low certainty).

• Combined corticosteroid and long‐acting beta₂‐agonist in one inhaler versus placebo for chronic obstructive pulmonary… 2013 · Cochrane Headline outcomes only
  OR 1.09 [0.95, 1.25]
  5574 participants
  Low

Combination fluticasone/salmeterol vs placebo

Fluticasone/salmeterol (FPS) showed no clear difference in adverse events—'serious' Duration of two years1 compared with placebo (low certainty).

• Combined corticosteroid and long‐acting beta₂‐agonist in one inhaler versus placebo for chronic obstructive pulmonary… 2013 · Cochrane Headline outcomes only
  OR 1.08 [0.95, 1.23]
  5531 participants
  Low

Budesonide/formoterol (BDF) vs placebo

Budesonide/formoterol (BDF) may leads to higher adverse event—any—320/94 Duration of nine months 3 compared with placebo (low certainty).

• Combined corticosteroid and long‐acting beta₂‐agonist in one inhaler versus placebo for chronic obstructive pulmonary… 2013 · Cochrane Headline outcomes only
  OR 1.42 [1.16, 1.74]
  1552 participants
  Low

Budesonide/formoterol (BDF) vs placebo

Budesonide/formoterol (BDF) may leads to higher adverse event—any—160/94 Duration of nine months 3 compared with placebo (low certainty).

• Combined corticosteroid and long‐acting beta₂‐agonist in one inhaler versus placebo for chronic obstructive pulmonary… 2013 · Cochrane Headline outcomes only
  OR 1.32 [1.08, 1.61]
  1556 participants
  Low

Intervention not reported

• Effect of longer‐term modest salt reduction on blood pressure 2013 · Cochrane Headline outcomes only
  no estimate extracted
  3206 participants
  High

Intervention not reported

• Effect of longer‐term modest salt reduction on blood pressure 2013 · Cochrane Headline outcomes only
  no estimate extracted
  3230 participants
  High

Intervention not reported

The intervention probably leads to lower exacerbation rates per participant per year (moderate certainty).

• Combined corticosteroid and long‐acting beta₂‐agonist in one inhaler versus inhaled corticosteroids alone for chronic… 2013 · Cochrane Headline outcomes only
  Rate ratio 0.87 [0.8, 0.94]
  6 studies · 5601 participants
  Moderate

Intervention not reported

The intervention leads to lower mortality (high certainty).

• Combined corticosteroid and long‐acting beta₂‐agonist in one inhaler versus inhaled corticosteroids alone for chronic… 2013 · Cochrane Headline outcomes only
  OR 0.78 [0.64, 0.94]
  12 studies · 7518 participants
  High

Intervention not reported

The intervention showed no clear difference in pneumonia (low certainty).

• Combined corticosteroid and long‐acting beta₂‐agonist in one inhaler versus inhaled corticosteroids alone for chronic… 2013 · Cochrane Headline outcomes only
  OR 1.08 [0.91, 1.28]
  12 studies · 7320 participants
  Low

Intervention not reported

The intervention showed no clear difference in hospitalisations due to COPD exacerbations (low certainty).

• Combined corticosteroid and long‐acting beta₂‐agonist in one inhaler versus inhaled corticosteroids alone for chronic… 2013 · Cochrane Headline outcomes only
  OR 0.93 [0.8, 1.07]
  10 studies · 7060 participants
  Low

Intervention not reported

The intervention showed no clear difference in adverse events－serious Fluticasone/salmeterol (FPS) versus… (low certainty).

• Combined corticosteroid and long‐acting beta₂‐agonist in one inhaler versus inhaled corticosteroids alone for chronic… 2013 · Cochrane Headline outcomes only
  OR 1.05 [0.82, 1.34]
  7 studies · 5055 participants
  Low