Cochrane · systematic review · CD007524
Increased versus stable doses of inhaled corticosteroids for exacerbations of chronic asthma in adults and children
Kew, KM, Flemyng, E, Quon, BS, et al. · Cochrane Database of Systematic Reviews · 2022 · 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
8
current version
GRADE rated
7
No studies
1
Included studies
NR
No studies 1 · 12.5%Ungraded 0 · 0%Very low 4 · 50%Low 2 · 25%Moderate 1 · 12.5%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 onlyIncreased versus stable doses of inhaled corticosteroids for exacerbations of chronic asthma in adults and children
Population: adults and children with chronic asthma
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcomes* Increased vs stable doses of inhaled corticosteroids | no estimate extracted | NR | No studies |
Treatment failure: need for systemic corticosteroids (ITT) Increased vs stable doses of inhaled corticosteroids | OR 0.97 [0.76, 1.25] | 8 studies · 1774 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Treatment failure: need for systemic corticosteroids (of those starting inhaler) Increased vs stable doses of inhaled corticosteroids | OR 0.84 [0.54, 1.3] | 7 studies · 766 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Unscheduled physician visits 44 weeks Increased vs stable doses of inhaled corticosteroids | OR 0.96 [0.66, 1.41] | 3 studies · 931 participants | Low Downgraded: risk of bias, imprecision, indirectness, publication bias |
Unscheduled acute care, ED visit, or hospital admission 47 weeks Increased vs stable doses of inhaled corticosteroids | 0.5 [0.16, 1.56] | 4 studies · 704 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Serious adverse events 48 weeks Increased vs stable doses of inhaled corticosteroids | OR 1.69 [0.77, 3.71] | 2 studies · 394 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Non‐serious adverse events 43 weeks Increased vs stable doses of inhaled corticosteroids | OR 2.15 [0.68, 6.73] | 2 studies · 142 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Duration of exacerbation ‐ time to symptom recovery and lung function recovery 52 weeks Increased vs stable doses of inhaled corticosteroids | no estimate extracted | 1 study · 207 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness, publication bias |
Comparison
Population: adults and children with chronic asthma
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Treatment failure ‐ need for systemic corticosteroids (ITT) | OR 0.89 [0.68, 1.18] | 7 studies · 1520 participants | Moderate Downgraded: imprecision |
Treatment failure ‐ need for systemic corticosteroids (of those starting inhaler) | OR 0.84 [0.54, 1.3] | 7 studies · 766 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness, publication bias |
Unscheduled physician visits 44 weeks | OR 0.96 [0.66, 1.41] | 3 studies · 931 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness, publication bias |
Unscheduled acute care, ED visit or hospital admission 47 weeks | OR 0.98 [0.24, 3.98] | 3 studies · 450 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness, publication bias |
Duration of exacerbation ‐ time to symptom recovery and lung function recovery 52 weeks | no estimate extracted | 1 study · 207 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, indirectness, publication bias |
Serious adverse events 48 weeks | OR 1.69 [0.77, 3.71] | 2 studies · 394 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, indirectness, publication bias |
Increased compared to stable inhaled steroid dose for exacerbations of chronic asthma in adults and children
Population: patients with exacerbations of chronic asthma (adults and children)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Need for rescue oral corticosteroids ‐ parallel‐group studies (ITT analysis) Increased vs stable inhaled steroid dose | OR 0.85 [0.58, 1.26] | 3 studies · 1080 participants | Moderate Downgraded: imprecision |
Non‐serious adverse events Increased vs stable inhaled steroid dose | OR 2.15 [0.68, 6.73] | 2 studies · 142 participants | Moderate Downgraded: imprecision |
Increased compared to stable inhaled steroid dose for exacerbations of chronic asthma in adults and children
Population: patients with exacerbations of chronic asthma (adults and children)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Need for rescue oral corticosteroids ‐ parallel‐group studies (ITT analysis) Increased vs stable inhaled steroid dose | OR 0.85 [0.58, 1.26] | 3 studies · 1080 participants | Moderate Downgraded: imprecision |
Non‐serious adverse events Increased vs stable inhaled steroid dose | OR 2.15 [0.68, 6.73] | 2 studies · 142 participants | Moderate Downgraded: imprecision |