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What do systematic reviews say?

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Evidence found and GRADE certainty

4,703 questions · 15,007 findings · 1,416 reviews

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No studies found 2,881 · 19.2%GRADE not reported 1,551 · 10.3%Very low 3,111 · 20.7%Low 3,881 · 25.9%Moderate 2,669 · 17.8%High 914 · 6.1%

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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

Macrolides vs placebo

Severe exacerbations requiring hospitalisation over the study period · adults and children with chronic asthma

Macrolides showed no clear difference in exacerbation requiring hospitalisation Weighted mean study duration:… compared with placebo (moderate certainty).

1 finding from 1 review

Macrolides vs placebo

Severe exacerbations (requiring ED visits or systemic steroids, or both) Number of people having ≥ 1 exacerbations requiring an ED visit or systemic steroids, or both. Classification varied across studies. Weighted mean study duration: 35 weeks · adults and children with chronic asthma

Macrolides probably leads to lower severe exacerbations (requiring ED visits or systemic steroids, or… compared with placebo (moderate certainty).

1 finding from 1 review