Findings

What do systematic reviews say?

509 questions · 514 findings · 44 reviews

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No studies found 35 · 6.8%GRADE not reported 31 · 6%Very low 41 · 8%Low 149 · 29%Moderate 196 · 38.1%High 62 · 12.1%

Triple therapy vs LABA/LAMA combination

Moderate‐to‐severe exacerbations (rate) · stable COPD

Triple therapy may leads to lower moderate‐to‐severe exacerbations (rate) compared with LABA/LAMA combination (low certainty).

1 finding from 1 review

Inhaled corticosteroids with combination inhaled long‐acting beta2‐agonists and long‐acting muscarinic antagonists for… 2023 · Cochrane Headline outcomes only
RR 0.74 [0.67, 0.81]
4 studies · 15397 participants
Low

Triple therapy vs LABA/LAMA combination

Severe exacerbations (rate) · stable COPD

Triple therapy may leads to lower severe exacerbations (rate) compared with LABA/LAMA combination (low certainty).

1 finding from 1 review

Inhaled corticosteroids with combination inhaled long‐acting beta2‐agonists and long‐acting muscarinic antagonists for… 2023 · Cochrane Headline outcomes only
RR 0.75 [0.67, 0.84]
3 studies · 14131 participants
Low

Triple therapy vs LABA/LAMA combination

Respiratory HRQoL measured by SGRQ, ≥ 4‐point decrease from baseline (lower scores indicate better HRQoL) · stable COPD

Triple therapy leads to higher respiratory HRQoL measured by SGRQ, ≥ 4‐point decrease from baseline… compared with LABA/LAMA combination (high certainty).

1 finding from 1 review

Inhaled corticosteroids with combination inhaled long‐acting beta2‐agonists and long‐acting muscarinic antagonists for… 2023 · Cochrane Headline outcomes only
OR 1.35 [1.26, 1.45]
3 studies · 14070 participants
High

Triple therapy vs LABA/LAMA combination

Pneumonia (labelled as an SAE) · stable COPD

Triple therapy probably leads to higher pneumonia (labelled as an SAE) compared with LABA/LAMA combination (moderate certainty).

1 finding from 1 review

Inhaled corticosteroids with combination inhaled long‐acting beta2‐agonists and long‐acting muscarinic antagonists for… 2023 · Cochrane Headline outcomes only
OR 1.74 [1.39, 2.18]
4 studies · 15412 participants
Moderate

Triple therapy vs LABA/LAMA combination

SAEs · stable COPD

Triple therapy showed no clear difference in all‐cause SAEs compared with LABA/LAMA combination (low certainty).

1 finding from 1 review

Inhaled corticosteroids with combination inhaled long‐acting beta2‐agonists and long‐acting muscarinic antagonists for… 2023 · Cochrane Headline outcomes only
OR 0.95 [0.87, 1.03]
4 studies · 15412 participants
Low

Triple therapy vs LABA/LAMA combination

Symptoms of dyspnoea · stable COPD

Triple therapy probably leads to higher symptom score TDI, ≥ 1‐unit increase (lower scores indicate worse… compared with LABA/LAMA combination (moderate certainty).

1 finding from 1 review

Inhaled corticosteroids with combination inhaled long‐acting beta2‐agonists and long‐acting muscarinic antagonists for… 2023 · Cochrane Headline outcomes only
OR 1.33 [1.13, 1.57]
1 study · 3044 participants
Moderate

Triple therapy vs LABA/LAMA combination

Change in baseline trough FEV1 · stable COPD

Triple therapy may leads to higher lung function, change in trough FEV1 (mL) compared with LABA/LAMA combination (low certainty).

1 finding from 1 review

Inhaled corticosteroids with combination inhaled long‐acting beta2‐agonists and long‐acting muscarinic antagonists for… 2023 · Cochrane Headline outcomes only
MD 38.68 [22.58, 54.77]
4 studies · 11352 participants
Low

Triple therapy vs LABA/LAMA combination

Mortality (all‐cause) · stable COPD

Triple therapy may leads to lower mortality (all‐cause) compared with LABA/LAMA combination (low certainty).

1 finding from 1 review

Inhaled corticosteroids with combination inhaled long‐acting beta2‐agonists and long‐acting muscarinic antagonists for… 2023 · Cochrane Headline outcomes only
OR 0.7 [0.54, 0.9]
4 studies · 15397 participants
Low

Intervention not reported

Total studies: 17 RCTs Total participants: 22,819 · 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
17 studies · 22819 participants
GRADE not reported

Intervention not reported

LD‐ICS/LABA (Direct evidence; 0 RCTs; 0 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
0 studies · 0 participants
Low

Intervention not reported

MD‐ICS/LAMA (Direct evidence; 2 RCTs; 679 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
2 studies · 679 participants
Low

Intervention not reported

MD‐ICS/LABA (Direct evidence; 12 RCTs; 7569 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
12 studies · 7569 participants
Moderate

Intervention not reported

HD‐ICS/LABA (Direct evidence; 2 RCTs; 1759 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
2 studies · 1759 participants
Moderate

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: 4 RCTs Total participants: 5681 · adolescents and adults with uncontrolled asthma, despite being on medium‐dose ICS Interventions: HD‐ICS, MD‐ICS/LABA, or HD‐ICS/LABA…

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 · 5681 participants
GRADE not reported

Intervention not reported

HD‐ICS (Direct evidence; 2 RCTs; 1005 participants) · adolescents and adults with uncontrolled asthma, despite being on medium‐dose ICS Interventions: HD‐ICS, MD‐ICS/LABA, or HD‐ICS/LABA…

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
2 studies · 1005 participants
High

Intervention not reported

MD‐ICS/LABA (Direct evidence; 1 RCT; 774 participants) · adolescents and adults with uncontrolled asthma, despite being on medium‐dose ICS Interventions: HD‐ICS, MD‐ICS/LABA, or HD‐ICS/LABA…

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 · 774 participants
Moderate

Intervention not reported

HD‐ICS/LABA (Direct evidence; 2 RCTs; 2863 participants) · adolescents and adults with uncontrolled asthma, despite being on medium‐dose ICS Interventions: HD‐ICS, MD‐ICS/LABA, or HD‐ICS/LABA…

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
2 studies · 2863 participants
High

Intervention not reported

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

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

HD‐ICS (Direct evidence; 4 RCTs; 3003 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 · 3003 participants
Moderate