Cochrane · systematic review · CD002997
Macrolides versus placebo for chronic asthma
Undela, K, Goldsmith, L, Kew, KM, et al. · 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
9
current version
GRADE rated
8
No studies
1
Included studies
NR
No studies 1 · 11.1%Ungraded 0 · 0%Very low 2 · 22.2%Low 4 · 44.4%Moderate 2 · 22.2%High 0 · 0%
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 onlyMacrolides compared to placebo for chronic asthma
Population: adults and children with chronic asthma
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcomesa Macrolides vs placebo | no estimate extracted | NR | No studies |
Exacerbation requiring hospitalisation Weighted mean study duration: 45 weeks Macrolides vs placebo | OR 0.47 [0.2, 1.12] | 2 studies · 529 participants | Moderate Downgraded: indirectness |
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 Macrolides vs placebo | Rate ratio 0.65 [0.53, 0.8] | 4 studies · 640 participants | Moderate Downgraded: indirectness |
Asthma symptoms – symptom scales (various scales; lower score = better) Weighted mean study duration: 10 weeks Macrolides vs placebo | no estimate extracted | 4 studies · 136 participants | Very low Downgraded: imprecision, inconsistency, indirectness |
Asthma control (Asthma Control Questionnaire) Scored 0–6 (lower scores indicate improvement in asthma control) Weighted mean study duration: 34 weeks Macrolides vs placebo | no estimate extracted | 5 studies · 773 participants | Low Downgraded: risk of bias, imprecision, indirectness |
Asthma quality of life (AQLQ) Scored 1–7 (higher scores indicate improvement in quality of life) Weighted mean study duration: 35 weeks Macrolides vs placebo | no estimate extracted | 6 studies · 802 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Rescue medication (puffs/day) Weighted mean study duration: 17 weeks Macrolides vs placebo | no estimate extracted | 4 studies · 314 participants | Low Downgraded: risk of bias, imprecision, indirectness |
FEV1 (L) Weighted mean study duration: 28 weeks Macrolides vs placebo | no estimate extracted | 10 studies · 1046 participants | Low Downgraded: risk of bias, imprecision, indirectness |
Serious adverse events (including mortality) Weighted mean study duration: 16 weeks Macrolides vs placebo | OR 0.8 [0.49, 1.31] | 8 studies · 854 participants | Low Downgraded: risk of bias, imprecision |
Macrolide compared to placebo for chronic asthma
Population: adults and children with chronic asthma
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcomesa Macrolide vs placebo | no estimate extracted | NR | No studies |
'Severe' exacerbation ‐ requiring at least OCS Number of people having one or more exacerbations requiring at least systemic steroids. Classification varied across studies. 18 weeks Macrolide vs placebo | OR 0.82 [0.43, 1.57] | 5 studies · 290 participants | Very low Downgraded: imprecision, indirectness, publication bias |
Symptom scales 10 weeks Macrolide vs placebo | no estimate extracted | 4 studies · 139 participants | Very low Downgraded: imprecision, inconsistency, indirectness, publication bias |
Asthma control Scored from 0 to 6 (lower scores indicate less impairment) Macrolide vs placebo | no estimate extracted | 4 studies · 353 participants | Very low Downgraded: risk of bias, imprecision, indirectness, publication bias |
Asthma Quality of Life Questionnaire (AQLQ) Scored from 1 to 7 (higher scores indicate less impairment) Macrolide vs placebo | no estimate extracted | 5 studies · 389 participants | Very low Downgraded: risk of bias, imprecision, indirectness, publication bias |
Rescue medication, puffs/day 17 weeks Macrolide vs placebo | no estimate extracted | 4 studies · 314 participants | Very low Downgraded: risk of bias, imprecision, indirectness, publication bias |
FEV1 (L) Macrolide vs placebo | no estimate extracted | 9 studies · 600 participants | Very low Downgraded: risk of bias, imprecision, indirectness, publication bias |
Serious adverse events (including mortality) Macrolide vs placebo | OR 0.96 [0.25, 3.68] | 7 studies · 359 participants | Very low Downgraded: risk of bias, imprecision |