Findings

What do systematic reviews say?

529 questions · 535 findings · 63 reviews · Airways

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No studies found 41 · 7.7%GRADE not reported 28 · 5.2%Very low 35 · 6.5%Low 151 · 28.2%Moderate 204 · 38.1%High 76 · 14.2%

Intervention not reported

Change from baseline in morning PEFR (L/min) Duration of trials: 6 to 16 weeks · adults and adolescents with persistent asthma

1 finding from 1 review

Addition of anti‐leukotriene agents to inhaled corticosteroids for adults and adolescents with persistent asthma 2017 · Cochrane Headline outcomes only
no estimate extracted
4 studies · 1489 participants
High

Intervention not reported

Change from baseline FEV1 (L) Duration of trials: 6 to 16 weeks · adults and adolescents with persistent asthma

1 finding from 1 review

Addition of anti‐leukotriene agents to inhaled corticosteroids for adults and adolescents with persistent asthma 2017 · Cochrane Headline outcomes only
no estimate extracted
3 studies · 760 participants
High

Intervention not reported

Change from baseline in mean asthma symptom score (daytime) Greater the reduction, better the outcome Duration of trials: 6 to 16 weeks · adults and adolescents with persistent asthma

1 finding from 1 review

Addition of anti‐leukotriene agents to inhaled corticosteroids for adults and adolescents with persistent asthma 2017 · Cochrane Headline outcomes only
no estimate extracted
3 studies · 1386 participants
High

Intervention not reported

Overall adverse effects Duration of trials: 6 to 16 weeks · adults and adolescents with persistent asthma

The intervention showed no clear difference in overall adverse effects Duration of trials: 6 to 16 weeks (moderate certainty).

1 finding from 1 review

Addition of anti‐leukotriene agents to inhaled corticosteroids for adults and adolescents with persistent asthma 2017 · Cochrane Headline outcomes only
RR 1.06 [0.92, 1.22]
3 studies · 1024 participants
Moderate

Intervention not reported

Death Duration of trials: 6 to 16 weeks · adults and adolescents with persistent asthma

The intervention showed no clear difference in death Duration of trials: 6 to 16 weeks (low certainty).

1 finding from 1 review

Addition of anti‐leukotriene agents to inhaled corticosteroids for adults and adolescents with persistent asthma 2017 · Cochrane Headline outcomes only
RR 0.35 [0.01, 8.49]
2 studies · 761 participants
Low

Intervention not reported

Change from baseline in morning PEFR (L/min) Duration of trials: 8 to 13 weeks · adults and adolescents with persistent asthma

1 finding from 1 review

Addition of anti‐leukotriene agents to inhaled corticosteroids for adults and adolescents with persistent asthma 2017 · Cochrane Headline outcomes only
no estimate extracted
5 studies · 952 participants
Low

Intervention not reported

Change from baseline FEV1 (L) Duration of trials: 8 to 13 weeks · adults and adolescents with persistent asthma

1 finding from 1 review

Addition of anti‐leukotriene agents to inhaled corticosteroids for adults and adolescents with persistent asthma 2017 · Cochrane Headline outcomes only
no estimate extracted
4 studies · 958 participants
Low

ICS dose reduction vs no change

Rate of exacerbations requiring systemic corticosteroids · adults with asthma

It is very uncertain whether ICS dose reduction changes exacerbation requiring OCS compared with no change (very low certainty).

2 findings from 1 review

Stepping down the dose of inhaled corticosteroids for adults with asthma 2017 · Cochrane Headline outcomes only
OR 1.86 [0.16, 21.09]
2 studies · 261 participants
Very low
Stepping down the dose of inhaled corticosteroids for adults with asthma 2017 · Cochrane Headline outcomes only
OR 1.31 [0.82, 2.08]
2 studies · 569 participants
Low

ICS dose reduction vs no change

SAEs · adults with asthma

ICS dose reduction showed no clear difference in all‐cause SAEs compared with no change (low certainty).

2 findings from 1 review

Stepping down the dose of inhaled corticosteroids for adults with asthma 2017 · Cochrane Headline outcomes only
OR 0.6 [0.11, 3.33]
2 studies · 569 participants
Low
Stepping down the dose of inhaled corticosteroids for adults with asthma 2017 · Cochrane Headline outcomes only
OR 1.24 [0.25, 6.25]
2 studies · 742 participants
Low

ICS dose reduction vs no change

Steroid‐related AEs ‐ not reported · adults with asthma

The review found no eligible studies for this question.

1 finding from 1 review

Stepping down the dose of inhaled corticosteroids for adults with asthma 2017 · Cochrane Headline outcomes only
no estimate extracted
Studies not reported
No studies found

ICS dose reduction vs no change

St. George's Respiratory Scale score (change from baseline) · adults with asthma

1 finding from 1 review

Stepping down the dose of inhaled corticosteroids for adults with asthma 2017 · Cochrane Headline outcomes only
no estimate extracted
1 study · 229 participants
Low

ICS dose reduction vs no change

Severe exacerbations requiring hospitalisation over the study period · adults with asthma

ICS dose reduction showed no clear difference in exacerbation requiring hospitalisation compared with no change (low certainty).

1 finding from 1 review

Stepping down the dose of inhaled corticosteroids for adults with asthma 2017 · Cochrane Headline outcomes only
OR 4.06 [0.45, 36.86]
2 studies · 569 participants
Low

ICS dose reduction vs no change

FEV1 · adults with asthma

1 finding from 1 review

Stepping down the dose of inhaled corticosteroids for adults with asthma 2017 · Cochrane Headline outcomes only
no estimate extracted
1 study · 14 participants
Very low

ICS dose reduction vs no change

Asthma control · adults with asthma

1 finding from 1 review

Stepping down the dose of inhaled corticosteroids for adults with asthma 2017 · Cochrane Headline outcomes only
no estimate extracted
1 study · 150 participants
Low

ICS dose reduction vs no change

Steroid‐related AEs · adults with asthma

It is very uncertain whether ICS dose reduction changes steroid‐related AEs compared with no change (very low certainty).

1 finding from 1 review

Stepping down the dose of inhaled corticosteroids for adults with asthma 2017 · Cochrane Headline outcomes only
OR 0.76 [0.16, 3.54]
2 studies · 261 participants
Very low

ICS dose reduction vs no change

Change in AQLQ · adults with asthma

1 finding from 1 review

Stepping down the dose of inhaled corticosteroids for adults with asthma 2017 · Cochrane Headline outcomes only
no estimate extracted
1 study · 554 participants
Very low

ICS dose reduction vs no change

FEV1 (L) · adults with asthma

1 finding from 1 review

Stepping down the dose of inhaled corticosteroids for adults with asthma 2017 · Cochrane Headline outcomes only
no estimate extracted
2 studies · 261 participants
Low

ICS dose reduction vs no change

Exacerbation: hospital 17 weeks · adults with asthma

The review found no eligible studies for this question.

1 finding from 1 review

Stepping down the dose of inhaled corticosteroids for adults with asthma 2017 · Cochrane Headline outcomes only
no estimate extracted
Studies not reported
No studies found

ICS dose reduction vs no change

Asthma control (short asthma morbidity score) · adults with asthma

1 finding from 1 review

Stepping down the dose of inhaled corticosteroids for adults with asthma 2017 · Cochrane Headline outcomes only
no estimate extracted
1 study · 242 participants
Low

Adherence education vs controls

Adherence · people with asthma

1 finding from 1 review

Interventions to improve adherence to inhaled steroids for asthma 2017 · Cochrane Headline outcomes only
no estimate extracted
5 studies · 280 participants
Low