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What do systematic reviews say?

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Evidence found and GRADE certainty

58 questions · 66 findings · 7 reviews · Airways

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No studies found 3 · 4.5%GRADE not reported 2 · 3%Very low 14 · 21.2%Low 17 · 25.8%Moderate 20 · 30.3%High 10 · 15.2%

Vitamin D vs placebo

Rate of exacerbations requiring systemic corticosteroids · children and adults with predominantly mild to moderate asthma

Summary of findings table ‐ Vitamin D showed no clear difference in proportion of participants with one or more exacerbations treated… compared with placebo (high certainty).

1 finding from 1 review

Vitamin D vs placebo

Patients with severe exacerbations (requiring hospitalisation or ER visit) · children and adults with predominantly mild to moderate asthma

Summary of findings table ‐ Vitamin D showed no clear difference in proportion of participants with one or more exacerbations requiring… compared with placebo (moderate certainty).

1 finding from 1 review

Vitamin D vs placebo

Proportion of participants with one or more serious adverse events due to any cause · children and adults with predominantly mild to moderate asthma

Summary of findings table ‐ Vitamin D showed no clear difference in proportion of participants with one or more serious adverse events… compared with placebo (high certainty).

1 finding from 1 review

Vitamin D vs placebo

Withdrawals (parallel group trials/first arm cross‐over trials) · children and adults with predominantly mild to moderate asthma

Summary of findings table ‐ Vitamin D showed no clear difference in withdrawals from trial compared with placebo (high certainty).

1 finding from 1 review

Summary of findings table ‐ immunostimulant vs placebo

Participants with no exacerbations in study period · adults with chronic bronchitis or chronic obstructive pulmonary disease

Summary of findings table ‐ immunostimulant probably leads to higher number of participants with no exacerbations during the study period compared with placebo (moderate certainty).

1 finding from 1 review

Summary of findings table ‐ immunostimulant vs placebo

Mortality (all‐cause) · adults with chronic bronchitis or chronic obstructive pulmonary disease

Summary of findings table ‐ immunostimulant showed no clear difference in mortality (all‐cause) compared with placebo (moderate certainty).

1 finding from 1 review

Summary of findings table ‐ immunostimulant vs placebo

Respiratory‐related mortality · adults with chronic bronchitis or chronic obstructive pulmonary disease

Summary of findings table ‐ immunostimulant showed no clear difference in mortality (respiratory‐related) compared with placebo (low certainty).

1 finding from 1 review

Summary of findings table ‐ immunostimulant vs placebo

Number of participants requiring antibiotics · adults with chronic bronchitis or chronic obstructive pulmonary disease

Summary of findings table ‐ immunostimulant probably leads to lower number of participants requiring antibiotics compared with placebo (moderate certainty).

1 finding from 1 review

Summary of findings table ‐ immunostimulant vs placebo

Side effects or other adverse events · adults with chronic bronchitis or chronic obstructive pulmonary disease

Summary of findings table ‐ immunostimulant showed no clear difference in adverse events/side effects compared with placebo (high certainty).

1 finding from 1 review