What do systematic reviews say?

Formoterol vs short‐acting beta2‐agonist

Formoterol probably leads to lower patients with an exacerbation requiring a course of oral… compared with short‐acting beta2‐agonist (moderate certainty).

• Formoterol versus short‐acting beta‐agonists as relief medication for adults and children with asthma 2010 · Cochrane Headline outcomes only
  OR 0.84 [0.77, 0.91]
  6 studies · 21591 participants
  Moderate

Treatment route: intravenous corticosteroid vs oral corticosteroid

Treatment route: intravenous corticosteroid showed no clear difference in mortality after discharge (1‐3 months) compared with oral corticosteroid (moderate certainty).

• Systemic corticosteroids for acute exacerbations of chronic obstructive pulmonary disease 2014 · Cochrane Headline outcomes only
  OR 1.4 [0.44, 4.51]
  3 studies · 298 participants
  Moderate

Treatment route: intravenous corticosteroid vs oral corticosteroid

• Systemic corticosteroids for acute exacerbations of chronic obstructive pulmonary disease 2014 · Cochrane Headline outcomes only
  no estimate extracted
  3 studies · 298 participants
  Low

Treatment route: intravenous corticosteroid vs oral corticosteroid

Treatment route: intravenous corticosteroid probably leads to higher adverse drug effect ‐ hyperglycaemia compared with oral corticosteroid (moderate certainty).

• Systemic corticosteroids for acute exacerbations of chronic obstructive pulmonary disease 2014 · Cochrane Headline outcomes only
  OR 4.89 [1.2, 19.94]
  1 study · 40 participants
  Moderate

Treatment route: intravenous corticosteroid vs oral corticosteroid

• Systemic corticosteroids for acute exacerbations of chronic obstructive pulmonary disease 2014 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 38 participants
  Low

Treatment route: intravenous corticosteroid vs oral corticosteroid

Treatment route: intravenous corticosteroid showed no clear difference in treatment failure Need to intensify therapy compared with oral corticosteroid (moderate certainty).

• Systemic corticosteroids for acute exacerbations of chronic obstructive pulmonary disease 2014 · Cochrane Headline outcomes only
  OR 0.67 [0.34, 1.3]
  3 studies · 298 participants
  Moderate

Treatment route: intravenous corticosteroid vs oral corticosteroid

Treatment route: intravenous corticosteroid showed no clear difference in relapse Hospital readmission for COPD compared with oral corticosteroid (moderate certainty).

• Systemic corticosteroids for acute exacerbations of chronic obstructive pulmonary disease 2014 · Cochrane Headline outcomes only
  OR 0.95 [0.5, 1.8]
  3 studies · 298 participants
  Moderate

Treatment route: intravenous corticosteroid vs oral corticosteroid

• Systemic corticosteroids for acute exacerbations of chronic obstructive pulmonary disease 2014 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 75 participants
  Low

Any ICS vs oral corticosteroid

Any ICS showed no clear difference in asthma relapse1at 16 to 21 days compared with oral corticosteroid (moderate certainty).

• Inhaled steroids for acute asthma following emergency department discharge 2012 · Cochrane Headline outcomes only
  OR 1.26 [0.8, 1.99]
  2 studies · 425 participants
  Moderate

Any ICS vs oral corticosteroid

Any ICS showed no clear difference in hospital admission compared with oral corticosteroid (moderate certainty).

• Inhaled steroids for acute asthma following emergency department discharge 2012 · Cochrane Headline outcomes only
  OR 0.31 [0.01, 7.95]
  3 studies · 254 participants
  Moderate

Any ICS vs oral corticosteroid

Any ICS showed no clear difference in hoarseness at 16 to 21 days compared with oral corticosteroid (low certainty).

• Inhaled steroids for acute asthma following emergency department discharge 2012 · Cochrane Headline outcomes only
  OR 1.62 [0.52, 5.05]
  1 study · 412 participants
  Low