Findings

What do systematic reviews say?

157 questions · 157 findings · 18 reviews · Airways

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No studies found 10 · 6.4%GRADE not reported 7 · 4.5%Very low 9 · 5.7%Low 36 · 22.9%Moderate 68 · 43.3%High 27 · 17.2%

Intervention not reported

LD‐ICS/LABA (Direct evidence; 1 RCT; 5846 participants) · adolescents and adults with uncontrolled asthma, despite being on medium‐dose ICS Interventions: HD‐ICS, LD‐ICS/LABA, MD‐ICS/LAMA,…

1 finding from 1 review

Addition of long‐acting beta2 agonists or long‐acting muscarinic antagonists versus doubling the dose of inhaled… 2023 · Cochrane Headline outcomes only
no estimate extracted
1 study · 5846 participants
High

Intervention not reported

MD‐ICS/LAMA (Direct evidence; 1 RCT; 282 participants) · adolescents and adults with uncontrolled asthma, despite being on medium‐dose ICS Interventions: HD‐ICS, LD‐ICS/LABA, MD‐ICS/LAMA,…

1 finding from 1 review

Addition of long‐acting beta2 agonists or long‐acting muscarinic antagonists versus doubling the dose of inhaled… 2023 · Cochrane Headline outcomes only
no estimate extracted
1 study · 282 participants
Low

Intervention not reported

MD‐ICS/LAMA (Direct evidence; 4 RCTs; 2239 participants) · adolescents and adults with uncontrolled asthma, despite being on medium‐dose ICS Interventions: HD‐ICS, LD‐ICS/LABA, MD‐ICS/LAMA,…

1 finding from 1 review

Addition of long‐acting beta2 agonists or long‐acting muscarinic antagonists versus doubling the dose of inhaled… 2023 · Cochrane Headline outcomes only
no estimate extracted
4 studies · 2239 participants
Moderate

Intervention not reported

MD‐ICS/LABA (Direct evidence; 21 RCTs; 20326 participants) · adolescents and adults with uncontrolled asthma, despite being on medium‐dose ICS Interventions: HD‐ICS, LD‐ICS/LABA, MD‐ICS/LAMA,…

1 finding from 1 review

Addition of long‐acting beta2 agonists or long‐acting muscarinic antagonists versus doubling the dose of inhaled… 2023 · Cochrane Headline outcomes only
no estimate extracted
21 studies · 20326 participants
High

Intervention not reported

HD‐ICS/LABA (Direct evidence; 4 RCTs; 2750 participants) · adolescents and adults with uncontrolled asthma, despite being on medium‐dose ICS Interventions: HD‐ICS, LD‐ICS/LABA, MD‐ICS/LAMA,…

1 finding from 1 review

Addition of long‐acting beta2 agonists or long‐acting muscarinic antagonists versus doubling the dose of inhaled… 2023 · Cochrane Headline outcomes only
no estimate extracted
4 studies · 2750 participants
High

Intervention not reported

MD‐ICS · adolescents and adults with uncontrolled asthma, despite being on medium‐dose ICS Interventions: HD‐ICS, LD‐ICS/LABA, MD‐ICS/LAMA,…

The review found no eligible studies for this question.

1 finding from 1 review

Addition of long‐acting beta2 agonists or long‐acting muscarinic antagonists versus doubling the dose of inhaled… 2023 · Cochrane Headline outcomes only
no estimate extracted
Studies not reported
No studies found

Intervention not reported

MD‐ICS/LABA (Direct evidence; 10 RCTs; 15,651 participants) · adolescents and adults with uncontrolled asthma, despite being on medium‐dose ICS Interventions: HD‐ICS, LD‐ICS/LABA, MD‐ICS/LAMA,…

1 finding from 1 review

Addition of long‐acting beta2 agonists or long‐acting muscarinic antagonists versus doubling the dose of inhaled… 2023 · Cochrane Headline outcomes only
no estimate extracted
10 studies · 15651 participants
Moderate

Intervention not reported

HD‐ICS/LABA (Direct evidence; 3 RCTs; 3319 participants) · adolescents and adults with uncontrolled asthma, despite being on medium‐dose ICS Interventions: HD‐ICS, LD‐ICS/LABA, MD‐ICS/LAMA,…

1 finding from 1 review

Addition of long‐acting beta2 agonists or long‐acting muscarinic antagonists versus doubling the dose of inhaled… 2023 · Cochrane Headline outcomes only
no estimate extracted
3 studies · 3319 participants
Low

Intervention not reported

MD‐ICS · adolescents and adults with uncontrolled asthma, despite being on medium‐dose ICS Interventions: HD‐ICS, LD‐ICS/LABA, MD‐ICS/LAMA,…

The review found no eligible studies for this question.

1 finding from 1 review

Addition of long‐acting beta2 agonists or long‐acting muscarinic antagonists versus doubling the dose of inhaled… 2023 · Cochrane Headline outcomes only
no estimate extracted
Studies not reported
No studies found

Intervention not reported

Total studies: 25 RCTs Total participants: 25,583 · adolescents and adults with uncontrolled asthma, despite being on medium‐dose ICS Interventions: HD‐ICS, LD‐ICS/LABA, MD‐ICS/LAMA,…

1 finding from 1 review

Addition of long‐acting beta2 agonists or long‐acting muscarinic antagonists versus doubling the dose of inhaled… 2023 · Cochrane Headline outcomes only
no estimate extracted
25 studies · 25583 participants
GRADE not reported

Intervention not reported

HD‐ICS (Direct evidence; 4 RCTs; 1685 participants) · adolescents and adults with uncontrolled asthma, despite being on medium‐dose ICS Interventions: HD‐ICS, LD‐ICS/LABA, MD‐ICS/LAMA,…

1 finding from 1 review

Addition of long‐acting beta2 agonists or long‐acting muscarinic antagonists versus doubling the dose of inhaled… 2023 · Cochrane Headline outcomes only
no estimate extracted
4 studies · 1685 participants
Moderate

Once‐daily ICS/LABA combined inhalers vs once‐daily LAMA

Mortality (all‐cause) · patients with chronic obstructive pulmonary disease

It is very uncertain whether once‐daily ICS/LABA combined inhalers changes mortality (all‐cause) compared with once‐daily LAMA (very low certainty).

1 finding from 1 review

Once‐daily long‐acting beta₂‐agonists/inhaled corticosteroids combined inhalers versus inhaled long‐acting muscarinic… 2018 · Cochrane Headline outcomes only
OR 0.2 [0.02, 1.73]
2 studies · 880 participants
Very low

Once‐daily ICS/LABA combined inhalers vs once‐daily LAMA

Any COPD exacerbation that requires short‐burst oral corticosteroids or antibiotics, or both · patients with chronic obstructive pulmonary disease

It is very uncertain whether once‐daily ICS/LABA combined inhalers changes any COPD exacerbation that requires short‐burst oral corticosteroids… compared with once‐daily LAMA (very low certainty).

1 finding from 1 review

Once‐daily long‐acting beta₂‐agonists/inhaled corticosteroids combined inhalers versus inhaled long‐acting muscarinic… 2018 · Cochrane Headline outcomes only
OR 0.72 [0.35, 1.5]
2 studies · 880 participants
Very low

Once‐daily ICS/LABA combined inhalers vs once‐daily LAMA

Pneumonia · patients with chronic obstructive pulmonary disease

It is very uncertain whether once‐daily ICS/LABA combined inhalers changes pneumonia compared with once‐daily LAMA (very low certainty).

1 finding from 1 review

Once‐daily long‐acting beta₂‐agonists/inhaled corticosteroids combined inhalers versus inhaled long‐acting muscarinic… 2018 · Cochrane Headline outcomes only
OR 6.12 [0.73, 51.24]
2 studies · 880 participants
Very low

Once‐daily ICS/LABA combined inhalers vs once‐daily LAMA

Quality of life · patients with chronic obstructive pulmonary disease

1 finding from 1 review

Once‐daily long‐acting beta₂‐agonists/inhaled corticosteroids combined inhalers versus inhaled long‐acting muscarinic… 2018 · Cochrane Headline outcomes only
no estimate extracted
2 studies · 779 participants
Very low

Once‐daily ICS/LABA combined inhalers vs once‐daily LAMA

Hospital admissions · patients with chronic obstructive pulmonary disease

It is very uncertain whether once‐daily ICS/LABA combined inhalers changes hospital admissions (all‐cause) compared with once‐daily LAMA (very low certainty).

1 finding from 1 review

Once‐daily long‐acting beta₂‐agonists/inhaled corticosteroids combined inhalers versus inhaled long‐acting muscarinic… 2018 · Cochrane Headline outcomes only
OR 0.96 [0.49, 1.89]
2 studies · 880 participants
Very low

Once‐daily ICS/LABA combined inhalers vs once‐daily LAMA

Exacerbations leading to intubation · patients with chronic obstructive pulmonary disease

The review found no eligible studies for this question.

1 finding from 1 review

Once‐daily long‐acting beta₂‐agonists/inhaled corticosteroids combined inhalers versus inhaled long‐acting muscarinic… 2018 · Cochrane Headline outcomes only
no estimate extracted
Studies not reported
No studies found

Once‐daily ICS/LABA combined inhalers vs once‐daily LAMA

Physical activity measure (e.g. 6MWT) · patients with chronic obstructive pulmonary disease

The review found no eligible studies for this question.

1 finding from 1 review

Once‐daily long‐acting beta₂‐agonists/inhaled corticosteroids combined inhalers versus inhaled long‐acting muscarinic… 2018 · Cochrane Headline outcomes only
no estimate extracted
Studies not reported
No studies found

Tiotropium + LABA/ICS combination vs tiotropium

Mortality (all‐cause) · patients with chronic obstructive pulmonary disease

Tiotropium + LABA/ICS combination showed no clear difference in mortality (all‐cause) compared with tiotropium (moderate certainty).

1 finding from 1 review

Combination inhaled steroid and long‐acting beta₂‐agonist in addition to tiotropium versus tiotropium or combination… 2016 · Cochrane Headline outcomes only
OR 1.8 [0.55, 5.91]
2 studies · 961 participants
Moderate

Tiotropium + LABA/ICS combination vs tiotropium

Hospital admissions · patients with chronic obstructive pulmonary disease

Tiotropium + LABA/ICS combination showed no clear difference in hospital admission (all causes) compared with tiotropium (low certainty).

1 finding from 1 review

Combination inhaled steroid and long‐acting beta₂‐agonist in addition to tiotropium versus tiotropium or combination… 2016 · Cochrane Headline outcomes only
OR 0.84 [0.53, 1.33]
2 studies · 961 participants
Low