Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

157 questions · 157 findings · 18 reviews · Airways

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%

IV + inhaled beta agonist vs inhaled beta‐agonist

Clinical Failure (children with a severe to moderate overall clinical assessment score at two hours) · patients with acute asthma

IV + inhaled beta agonist probably leads to lower clinical Failure (children with a severe to moderate overall… compared with inhaled beta‐agonist (moderate certainty).

1 finding from 1 review

Anticholinergic and short‐acting beta2‐agonists vs B2‐agonists alone

Hospital admissions · children with initial treatment of acute asthma

Anticholinergic and short‐acting beta2‐agonists leads to lower primary outcome: hospital admissions hospital admissions compared with beta2‐agonists alone (all protocols) (high certainty).

1 finding from 1 review

Combination of anticholinergics + beta2‐agonists vs B2‐agonists alone

Asthma clinical scores · children hospitalised with an acute asthma exacerbation

Combination of anticholinergics + beta2‐agonists showed no clear difference in asthma clinical scores compared with beta2‐agonists alone (moderate certainty).

1 finding from 1 review

Combination of anticholinergics + beta2‐agonists vs B2‐agonists alone

Overall withdrawals · children hospitalised with an acute asthma exacerbation

Combination of anticholinergics + beta2‐agonists showed no clear difference in overall withdrawals compared with beta2‐agonists alone (moderate certainty).

1 finding from 1 review

LABA/LAMA vs LABA plus inhaled corticosteroid (ICS)

Exacerbations (number of people experiencing ≥ 1 exacerbations) · stable COPD

Long‐acting muscarinic antagonist (LAMA) plus long‐acting… showed no clear difference in exacerbations (number of people experiencing ≥ 1 exacerbations) compared with LABA plus inhaled corticosteroid (ICS) (moderate certainty).

1 finding from 1 review

LABA/LAMA vs LABA plus inhaled corticosteroid (ICS)

Number of participants experiencing any serious adverse events · stable COPD

Long‐acting muscarinic antagonist (LAMA) plus long‐acting… showed no clear difference in serious adverse events (number of people experiencing ≥ 1 SAEs) compared with LABA plus inhaled corticosteroid (ICS) (high certainty).

1 finding from 1 review

LABA/LAMA vs LABA plus inhaled corticosteroid (ICS)

Change in SGRQ total score · stable COPD

Long‐acting muscarinic antagonist (LAMA) plus long‐acting… showed no clear difference in quality of life as measured by SGRQ total score change from baseline… compared with LABA plus inhaled corticosteroid (ICS) (moderate certainty).

1 finding from 1 review

LABA/LAMA vs LABA plus inhaled corticosteroid (ICS)

Change in baseline trough FEV1 · stable COPD

Long‐acting muscarinic antagonist (LAMA) plus long‐acting… probably leads to higher trough FEV1 change from baseline compared with LABA plus inhaled corticosteroid (ICS) (moderate certainty).

1 finding from 1 review

LABA/LAMA vs LABA plus inhaled corticosteroid (ICS)

All‐cause death · stable COPD

Long‐acting muscarinic antagonist (LAMA) plus long‐acting… probably leads to higher all‐cause death compared with LABA plus inhaled corticosteroid (ICS) (moderate certainty).

1 finding from 1 review

LABA/LAMA vs LABA plus inhaled corticosteroid (ICS)

SGRQ total score change from baseline (≥ 4 points, MCID) · stable COPD

Long‐acting muscarinic antagonist (LAMA) plus long‐acting… showed no clear difference in SGRQ total score change from baseline (≥ 4 points, MCID) compared with LABA plus inhaled corticosteroid (ICS) (moderate certainty).

1 finding from 1 review

LAMA add‐on vs long‐acting beta2‐agonists (LABA) add‐on

Exacerbations (OCS) · adults with asthma not well controlled on ICS

Long‐acting muscarinic antagonists (LAMA) add‐on showed no clear difference in exacerbations (OCS) compared with long‐acting beta2‐agonists (LABA) add‐on (low certainty).

1 finding from 1 review