What do systematic reviews say?

Intramuscular corticosteroids vs oral corticosteroid

Intramuscular corticosteroids showed no clear difference in 24‐hour beta agonist use compared with oral corticosteroids (low certainty).

• Intramuscular versus oral corticosteroids to reduce relapses following discharge from the emergency department for… 2018 · Cochrane Headline outcomes only
  RR 0.54 [0.21, 1.37]
  2 studies · 48 participants
  Low

Pembrolizumab vs chemotherapy alone

Pembrolizumab probably leads to lower time to death from any cause (here: overall mortality at 12‐month compared with chemotherapy (moderate certainty).

• Pembrolizumab monotherapy versus chemotherapy for treatment of advanced urothelial carcinoma with disease progression… 2018 · Cochrane Headline outcomes only
  HR 0.73 [0.59, 0.9]
  1 study · 542 participants
  Moderate

Pembrolizumab vs chemotherapy alone

Pembrolizumab may leads to higher quality of life (Change from baseline to week 15) compared with chemotherapy (low certainty).

• Pembrolizumab monotherapy versus chemotherapy for treatment of advanced urothelial carcinoma with disease progression… 2018 · Cochrane Headline outcomes only
  MD 9.05 [4.61, 13.5]
  1 study · 519 participants
  Low

Pembrolizumab vs chemotherapy alone

Pembrolizumab probably leads to higher response rate (partial and complete response) compared with chemotherapy (moderate certainty).

• Pembrolizumab monotherapy versus chemotherapy for treatment of advanced urothelial carcinoma with disease progression… 2018 · Cochrane Headline outcomes only
  RR 1.85 [1.24, 2.77]
  1 study · 542 participants
  Moderate

Pembrolizumab vs chemotherapy alone

Pembrolizumab showed no clear difference in treatment‐related mortality compared with chemotherapy (low certainty).

• Pembrolizumab monotherapy versus chemotherapy for treatment of advanced urothelial carcinoma with disease progression… 2018 · Cochrane Headline outcomes only
  RR 0.96 [0.24, 3.79]
  1 study · 521 participants
  Low

Pembrolizumab vs chemotherapy alone

Pembrolizumab showed no clear difference in discontinuation due to adverse event compared with chemotherapy (low certainty).

• Pembrolizumab monotherapy versus chemotherapy for treatment of advanced urothelial carcinoma with disease progression… 2018 · Cochrane Headline outcomes only
  RR 0.66 [0.39, 1.1]
  1 study · 521 participants
  Low

Pembrolizumab vs chemotherapy alone

Pembrolizumab may leads to lower serious adverse events (irrespective of attribution to treatment) compared with chemotherapy (low certainty).

• Pembrolizumab monotherapy versus chemotherapy for treatment of advanced urothelial carcinoma with disease progression… 2018 · Cochrane Headline outcomes only
  RR 0.83 [0.72, 0.97]
  1 study · 521 participants
  Low

Bethanechol vs Artificial saliva

Bethanechol showed no clear difference in xerostomia (dry mouth, yes/no) compared with artificial saliva; GRADE not reported.

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes

  8 to 40 weeks postRT
  RR 0.56 [0.30, 1.05]
  1 study · 30 participants
  GRADE not reported

Keratinocyte growth factor (KGF; palifermin or repifermin), intravenous vs placebo

Palifermin showed no clear difference in progression-free survival compared with placebo; GRADE not reported.

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes

  42 to 72 months from baseline
  HR 1.06 [0.80, 1.42]
  3 studies
  GRADE not reported

Bethanechol vs Artificial saliva

Bethanechol showed no clear difference in overall survival compared with artificial saliva; GRADE not reported.

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes

  40 weeks postRT
  RR 1.59 [0.43, 5.84]
  1 study · 43 participants
  GRADE not reported

Amifostine vs no treatment/placebo

Amifostine showed no clear difference in dysphagia (grade >= 3, 0-4 scale) compared with no treatment/placebo; GRADE not reported.

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes

  End of RT; up to 3 months postRT
  RR 0.50 [0.17, 1.48]
  2 studies · 73 participants
  GRADE not reported

Polaprezinc vs Azulene oral rinse

The review found no eligible studies for this question.

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
  No data on adverse events were reported.
  0 studies
  No studies found

Polaprezinc vs Azulene oral rinse

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
  Tumour response by RECIST criteria reported for a specific group of patients only; no usable survival data (Watanabe 2010)
  1 study
  GRADE not reported

Keratinocyte growth factor (KGF; palifermin or repifermin), intravenous vs placebo

Palifermin showed no clear difference in xerostomia (grade >= 2, 0-4 scale) compared with placebo (low certainty).

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes

  Up to and including 3 months postRT
  RR 0.97 [0.77, 1.22]
  3 studies · 471 participants
  Low

Antiseptic mouthrinse vs placebo

Antiseptic mouthrinse showed no clear difference in drooling (hyposialosis) compared with placebo; GRADE not reported.

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes

  4 weeks from baseline
  RR 1.43 [0.46, 4.39]
  1 study · 24 participants
  GRADE not reported

Pilocarpine vs no treatment/placebo

It is very uncertain whether pilocarpine changes quality of life (McMaster HNRQ, 1-7 scale) compared with no treatment/placebo (very low certainty).

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes

  Up to and including 6 months postRT
  MD 0.20 [-0.19, 0.59]
  1 study · 90 participants
  Very low

Amifostine vs no treatment/placebo

Amifostine showed no clear difference in disease-free survival compared with no treatment/placebo; GRADE not reported.

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes

  24 months postRT
  RR 0.94 [0.73, 1.21]
  1 study · 170 participants
  GRADE not reported

Chinese medicine vs no treatment/placebo

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes

  End of intervention; 1 month after RT
  Insufficient evidence of a difference for any side effects
  2 studies
  GRADE not reported

Amifostine vs no treatment/placebo

Amifostine showed no clear difference in quality of life compared with no treatment/placebo; GRADE not reported.

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes

  End of RT; up to 3 months postRT
  MD 0.52 [-0.02, 1.06]
  1 study · 233 participants
  GRADE not reported

Amifostine vs no treatment/placebo

Amifostine showed no clear difference in progression-free survival compared with no treatment/placebo; GRADE not reported.

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes

  12 to 24 months postRT
  HR 0.94 [0.70, 1.27]
  2 studies · 247 participants
  GRADE not reported