Findings

What do systematic reviews say?

13 questions · 13 findings · 8 reviews · Airways · Headline outcomes only

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No studies found 0 · 0%GRADE not reported 0 · 0%Very low 1 · 7.7%Low 3 · 23.1%Moderate 7 · 53.8%High 2 · 15.4%

Any ICS vs oral corticosteroid

Asthma relapse1at 16 to 21 days · patients with acute asthma following emergency department discharge

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

1 finding from 1 review

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

Hospital admissions · patients with acute asthma following emergency department discharge

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

1 finding from 1 review

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

Hoarseness at 16 to 21 days · patients with acute asthma following emergency department discharge

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

1 finding from 1 review

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

Any ICS plus oral corticosteroid vs oral corticosteroid

Asthma relapse1at 20 to 24 days · predominantly adults with acute asthma following emergency department discharge

Any ICS plus oral corticosteroid showed no clear difference in asthma relapse1at 20 to 24 days compared with oral corticosteroid (high certainty).

1 finding from 1 review

Inhaled steroids for acute asthma following emergency department discharge 2012 · Cochrane Headline outcomes only
OR 0.68 [0.46, 1.02]
3 studies · 909 participants
High

Any ICS plus oral corticosteroid vs oral corticosteroid

Hospital admissions · predominantly adults with acute asthma following emergency department discharge

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

1 finding from 1 review

Inhaled steroids for acute asthma following emergency department discharge 2012 · Cochrane Headline outcomes only
OR 0.99 [0.39, 2.52]
2 studies · 805 participants
Moderate

Any ICS plus oral corticosteroid vs oral corticosteroid

Hoarseness at 20 to 24 days · predominantly adults with acute asthma following emergency department discharge

Any ICS plus oral corticosteroid showed no clear difference in hoarseness at 20 to 24 days compared with oral corticosteroid (moderate certainty).

1 finding from 1 review

Inhaled steroids for acute asthma following emergency department discharge 2012 · Cochrane Headline outcomes only
OR 0.6 [0.36, 1.01]
2 studies · 596 participants
Moderate

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

LABA/ICS vs LTRA + ICS

Withdrawals due to any reason · patients with chronic asthma

LABA + ICS probably leads to lower withdrawals for any reason compared with LTRA + ICS (moderate certainty).

1 finding from 1 review

Addition to inhaled corticosteroids of long‐acting beta₂‐agonists versus anti‐leukotrienes for chronic asthma 2014 · Cochrane Headline outcomes only
RR 0.84 [0.74, 0.96]
13 studies · 6960 participants
Moderate

Antibiotics vs placebo

Any adverse event WMD of · Adults (aged 40 or over) with COPD presenting with 1 or more exacerbations in the previous year. The 2 larger studies (Albert 2011; Sethi…

Antibiotics showed no clear difference in any adverse event WMD of compared with placebo (moderate certainty).

1 finding from 1 review

Prophylactic antibiotic therapy for chronic obstructive pulmonary disease (COPD) 2018 · Cochrane Headline outcomes only
OR 1.07 [0.69, 1.67]
4 studies · 512 participants
Moderate

Antibiotics vs placebo overall

Adverse events (timing not specified) · exacerbations of COPD

Antibiotics showed no clear difference in adverse events ‐ overall (any adverse events not specified) compared with placebo overall (moderate certainty).

1 finding from 1 review

Antibiotics for exacerbations of chronic obstructive pulmonary disease 2018 · Cochrane Headline outcomes only
OR 1.2 [0.89, 1.63]
6 studies · 1544 participants
Moderate

LAMA add‐on vs ICS alone

Any adverse events 24 weeks · adults with asthma not well controlled on ICS

LAMA add‐on showed no clear difference in any adverse events 24 weeks compared with ICS alone (low certainty).

1 finding from 1 review

Long‐acting muscarinic antagonists (LAMA) added to inhaled corticosteroids (ICS) versus the same dose of ICS alone for… 2015 · Cochrane Headline outcomes only
OR 0.95 [0.8, 1.14]
5 studies · 2562 participants
Low

School‐based ICS therapy vs home therapy

Unscheduled visits 1 or more hospitalisations for any cause WMD of · children with asthma

School‐based ICS therapy showed no clear difference in unscheduled visits 1 or more hospitalisations for any cause WMD of compared with home therapy (low certainty).

1 finding from 1 review

Interventions to improve adherence to inhaled steroids for asthma 2017 · Cochrane Headline outcomes only
OR 0.58 [0.16, 2.05]
2 studies · 279 participants
Low

Intervention not reported

Any adverse events 49 weeks · adults with asthma

The intervention leads to lower any adverse events 49 weeks (high certainty).

1 finding from 1 review

Long‐acting muscarinic antagonists (LAMA) added to combination long‐acting beta₂‐agonists and inhaled corticosteroids… 2016 · Cochrane Headline outcomes only
OR 0.7 [0.52, 0.94]
3 studies · 1197 participants
High