Cochrane · systematic review · CD001127
Dornase alfa for cystic fibrosis
Yang, C, Montgomery, M · Cochrane Database of Systematic Reviews · 2021 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
23
current version
GRADE rated
23
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 0 · 0%Low 18 · 78.3%Moderate 3 · 13%High 2 · 8.7%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyDornase alfa versus placebo or no dornase alfa treatment
Population: Adults and children with cystic fibrosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Relative mean percentage change in FEV1 (% predicted) at 3 months Dornase alfa vs placebo or no dornase alfa treatment | no estimate extracted | 1 study · 320 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, indirectness, publication bias |
Relative mean percentage change in FEV1 (% predicted) at 6 months Dornase alfa vs placebo or no dornase alfa treatment | no estimate extracted | 1 study · 647 participants | High |
Relative mean percentage change in FVC (% predicted) at 3 months Dornase alfa vs placebo or no dornase alfa treatment | no estimate extracted | 1 study · 318 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, indirectness, publication bias |
Relative mean percentage change in FVC (% predicted) at 6 months Dornase alfa vs placebo or no dornase alfa treatment | MD 3.8 [2.62, 4.98] | 1 study · 647 participants | High |
Change in quality of life ‐ CFQ‐R respiratory at 1 month Dornase alfa vs placebo or no dornase alfa treatment | MD 0.84 | 19 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness, publication bias |
Change in quality of life ‐ CFQ‐R respiratory (parent) at 1 month Dornase alfa vs placebo or no dornase alfa treatment | MD 9.78 | 19 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness, publication bias |
Number of people experiencing exacerbations at up to 2 years Dornase alfa vs placebo or no dornase alfa treatment | RR 0.78 [0.62, 0.96] | 3 studies · 1157 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, indirectness, publication bias |
Dornase alfa daily versus alternate days
Population: Children with cystic fibrosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mean relative percentage change in FEV1 (L) at 3 months Dornase alfa daily vs alternate days | MD 2 | 43 participants | Low Downgraded: risk of bias, indirectness |
Mean relative percentage in FVC (L) at 3 months Dornase alfa daily vs alternate days | MD 0.03 | 43 participants | Low Downgraded: risk of bias, indirectness |
Mean relative percentage in quality of life score at 3 months Dornase alfa daily vs alternate days | MD 0.01 | 43 participants | Low Downgraded: risk of bias, indirectness |
Number of pulmonary exacerbations at 3 months Dornase alfa daily vs alternate days | no estimate extracted | 43 participants | Low Downgraded: risk of bias, indirectness |
Dornase alfa versus hypertonic saline
Population: Children with cystic fibrosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mean relative percentage in FEV1 (L) at 3 months Dornase alfa vs hypertonic saline | MD 8 [2, 14] | 431 participants | Low Downgraded: risk of bias, indirectness |
Mean relative percentage in FVC (L) at 3 months Dornase alfa vs hypertonic saline | MD 0.08 | 431 participants | Low Downgraded: risk of bias, indirectness |
Mean relative percentage in quality of life score at 3 months Dornase alfa vs hypertonic saline | MD 0.03 | 431 participants | Low Downgraded: risk of bias, indirectness |
Number of pulmonary exacerbations at 3 months Dornase alfa vs hypertonic saline | no estimate extracted | 431 participants | Low Downgraded: risk of bias, indirectness |
Dornase alfa versus mannitol
Population: Children with cystic fibrosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mean absolute change in FEV1 (L) at 3 months Dornase alfa vs mannitol | MD 0.02 | 231 participants | Low Downgraded: risk of bias, indirectness |
Mean absolute change in FVC (L) at 3 months Dornase alfa vs mannitol | no estimate extracted | 231 participants | Low Downgraded: risk of bias, indirectness |
Change in quality of life ‐ CFQ‐R at 3 months Dornase alfa vs mannitol | MD 10.61 [0.27, 20.95] | 231 participants | Low Downgraded: risk of bias, indirectness |
Number of people experiencing exacerbations ‐ at 3 months Dornase alfa vs mannitol | RR 1.1 [0.25, 4.84] | 231 participants | Low Downgraded: risk of bias, indirectness |
Dornase alfa versus dornase alfa and mannitol
Population: Children with cystic fibrosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mean absolute change in FEV1 (L) at 3 months Dornase alfa vs dornase alfa and mannitol | MD 0.1 | 231 participants | Low Downgraded: risk of bias, indirectness |
Mean absolute change in FVC (L) at 3 months Dornase alfa vs dornase alfa and mannitol | MD 0.13 | 231 participants | Low Downgraded: risk of bias, indirectness |
Change in quality of life ‐ CFQ‐R at 3 months Dornase alfa vs dornase alfa and mannitol | MD 10.61 [0.27, 20.95] | 231 participants | Low Downgraded: risk of bias, indirectness |
Number of people experiencing exacerbations at 3 months Dornase alfa vs dornase alfa and mannitol | RR 0.55 [0.16, 1.92] | 231 participants | Low Downgraded: risk of bias, indirectness |
Dornase alfa versus placebo or no dornase alfa treatment
Population: Adults and children with cystic fibrosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Relative mean percentage change in FEV1 (% predicted) at 3 months Dornase alfa vs placebo or no dornase alfa treatment | no estimate extracted | 1 study · 320 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, indirectness, publication bias |
Relative mean percentage change in FEV1 (% predicted) at 6 months Dornase alfa vs placebo or no dornase alfa treatment | no estimate extracted | 1 study · 647 participants | High |
Relative mean percentage change in FVC (% predicted) at 3 months Dornase alfa vs placebo or no dornase alfa treatment | no estimate extracted | 1 study · 318 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, indirectness, publication bias |
Relative mean percentage change in FVC (% predicted) at 6 months Dornase alfa vs placebo or no dornase alfa treatment | MD 3.8 [2.62, 4.98] | 1 study · 647 participants | High |
Change in quality of life ‐ CFQ‐R respiratory at 1 month Dornase alfa vs placebo or no dornase alfa treatment | MD 0.84 | 19 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness, publication bias |
Change in quality of life ‐ CFQ‐R respiratory (parent) at 1 month Dornase alfa vs placebo or no dornase alfa treatment | MD 9.78 | 19 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness, publication bias |
Number of people experiencing exacerbations at up to 2 years Dornase alfa vs placebo or no dornase alfa treatment | RR 0.78 [0.62, 0.96] | 3 studies · 1157 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, indirectness, publication bias |
Dornase alfa daily versus alternate days
Population: Children with cystic fibrosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mean relative percentage change in FEV1 (L) at 3 months Dornase alfa daily vs alternate days | MD 2 | 43 participants | Low Downgraded: risk of bias, indirectness |
Mean relative percentage in FVC (L) at 3 months Dornase alfa daily vs alternate days | MD 0.03 | 43 participants | Low Downgraded: risk of bias, indirectness |
Mean relative percentage in quality of life score at 3 months Dornase alfa daily vs alternate days | MD 0.01 | 43 participants | Low Downgraded: risk of bias, indirectness |
Number of pulmonary exacerbations at 3 months Dornase alfa daily vs alternate days | no estimate extracted | 43 participants | Low Downgraded: risk of bias, indirectness |
Dornase alfa versus hypertonic saline
Population: Children with cystic fibrosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mean relative percentage in FEV1 (L) at 3 months Dornase alfa vs hypertonic saline | MD 8 [2, 14] | 431 participants | Low Downgraded: risk of bias, indirectness |
Mean relative percentage in FVC (L) at 3 months Dornase alfa vs hypertonic saline | MD 0.08 | 431 participants | Low Downgraded: risk of bias, indirectness |
Mean relative percentage in quality of life score at 3 months Dornase alfa vs hypertonic saline | MD 0.03 | 431 participants | Low Downgraded: risk of bias, indirectness |
Number of pulmonary exacerbations at 3 months Dornase alfa vs hypertonic saline | no estimate extracted | 431 participants | Low Downgraded: risk of bias, indirectness |
Dornase alfa versus mannitol
Population: Children with cystic fibrosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mean absolute change in FEV1 (L) at 3 months Dornase alfa vs mannitol | MD 0.02 | 231 participants | Low Downgraded: risk of bias, indirectness |
Mean absolute change in FVC (L) at 3 months Dornase alfa vs mannitol | no estimate extracted | 231 participants | Low Downgraded: risk of bias, indirectness |
Change in quality of life ‐ CFQ‐R at 3 months Dornase alfa vs mannitol | MD 10.61 [0.27, 20.95] | 231 participants | Low Downgraded: risk of bias, indirectness |
Number of people experiencing exacerbations ‐ at 3 months Dornase alfa vs mannitol | RR 1.1 [0.25, 4.84] | 231 participants | Low Downgraded: risk of bias, indirectness |
Dornase alfa versus dornase alfa and mannitol
Population: Children with cystic fibrosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mean absolute change in FEV1 (L) at 3 months Dornase alfa vs dornase alfa and mannitol | MD 0.1 | 231 participants | Low Downgraded: risk of bias, indirectness |
Mean absolute change in FVC (L) at 3 months Dornase alfa vs dornase alfa and mannitol | MD 0.13 | 231 participants | Low Downgraded: risk of bias, indirectness |
Change in quality of life ‐ CFQ‐R at 3 months Dornase alfa vs dornase alfa and mannitol | MD 10.61 [0.27, 20.95] | 231 participants | Low Downgraded: risk of bias, indirectness |
Number of people experiencing exacerbations at 3 months Dornase alfa vs dornase alfa and mannitol | RR 0.55 [0.16, 1.92] | 231 participants | Low Downgraded: risk of bias, indirectness |
Dornase alfa versus placebo or no dornase alfa treatment
Population: Adults and children with cystic fibrosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Relative mean percentage change in FEV1 (% predicted) at 3 months Dornase alfa vs placebo or no dornase alfa treatment | no estimate extracted | 1 study · 320 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, indirectness, publication bias |
Relative mean percentage change in FEV1 (% predicted) at 6 months Dornase alfa vs placebo or no dornase alfa treatment | no estimate extracted | 1 study · 647 participants | High |
Relative mean percentage change in FVC (% predicted) at 3 months Dornase alfa vs placebo or no dornase alfa treatment | no estimate extracted | 1 study · 318 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, indirectness, publication bias |
Change in quality of life ‐ CFQ‐R respiratory at 1 month Dornase alfa vs placebo or no dornase alfa treatment | MD 0.84 | 19 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness, publication bias |
Change in quality of life ‐ CFQ‐R respiratory (parent) at 1 month Dornase alfa vs placebo or no dornase alfa treatment | MD 9.78 | 19 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness, publication bias |
Number of people experiencing exacerbations at up to 2 years Dornase alfa vs placebo or no dornase alfa treatment | RR 0.78 [0.62, 0.96] | 3 studies · 1157 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, indirectness, publication bias |
Dornase alfa daily versus alternate days
Population: Children with cystic fibrosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mean relative percentage change in FEV1 (L) at 3 months Dornase alfa daily vs alternate days | MD 2 | 43 participants | Low Downgraded: risk of bias, indirectness |
Mean relative percentage in FVC (L) at 3 months Dornase alfa daily vs alternate days | MD 0.03 | 43 participants | Low Downgraded: risk of bias, indirectness |
Mean relative percentage in quality of life score at 3 months Dornase alfa daily vs alternate days | MD 0.01 | 43 participants | Low Downgraded: risk of bias, indirectness |
Number of pulmonary exacerbations at 3 months Dornase alfa daily vs alternate days | no estimate extracted | 43 participants | Low Downgraded: risk of bias, indirectness |
Dornase alfa versus hypertonic saline
Population: Children with cystic fibrosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mean relative percentage in FEV1 (L) at 3 months Dornase alfa vs hypertonic saline | MD 8 [2, 14] | 431 participants | Low Downgraded: risk of bias, indirectness |
Mean relative percentage in FVC (L) at 3 months Dornase alfa vs hypertonic saline | MD 0.08 | 431 participants | Low Downgraded: risk of bias, indirectness |
Mean relative percentage in quality of life score at 3 months Dornase alfa vs hypertonic saline | MD 0.03 | 431 participants | Low Downgraded: risk of bias, indirectness |
Number of pulmonary exacerbations at 3 months Dornase alfa vs hypertonic saline | no estimate extracted | 431 participants | Low Downgraded: risk of bias, indirectness |
Dornase alfa versus mannitol
Population: Children with cystic fibrosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mean absolute change in FEV1 (L) at 3 months Dornase alfa vs mannitol | MD 0.02 | 231 participants | Low Downgraded: risk of bias, indirectness |
Mean absolute change in FVC (L) at 3 months Dornase alfa vs mannitol | no estimate extracted | 231 participants | Low Downgraded: risk of bias, indirectness |
Change in quality of life ‐ CFQ‐R at 3 months Dornase alfa vs mannitol | MD 10.61 [0.27, 20.95] | 231 participants | Low Downgraded: risk of bias, indirectness |
Number of people experiencing exacerbations ‐ at 3 months Dornase alfa vs mannitol | RR 1.1 [0.25, 4.84] | 231 participants | Low Downgraded: risk of bias, indirectness |
Dornase alfa versus dornase alfa and mannitol
Population: Children with cystic fibrosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mean absolute change in FEV1 (L) at 3 months Dornase alfa vs dornase alfa and mannitol | MD 0.1 | 231 participants | Low Downgraded: risk of bias, indirectness |
Mean absolute change in FVC (L) at 3 months Dornase alfa vs dornase alfa and mannitol | MD 0.13 | 231 participants | Low Downgraded: risk of bias, indirectness |
Change in quality of life ‐ CFQ‐R at 3 months Dornase alfa vs dornase alfa and mannitol | MD 10.61 [0.27, 20.95] | 231 participants | Low Downgraded: risk of bias, indirectness |
Number of people experiencing exacerbations at 3 months Dornase alfa vs dornase alfa and mannitol | RR 0.55 [0.16, 1.92] | 231 participants | Low Downgraded: risk of bias, indirectness |