Cochrane · systematic review · CD008649

Inhaled mannitol for cystic fibrosis

Nevitt, SJ, Thornton, J, Murray, CS, et al. · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library

Cystic Fibrosis and Genetic Disorders3 versionsAMSTAR 2: not assessed
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
30
current version
GRADE rated
27
No studies
3
Included studies
NR
No studies 3 · 10%Ungraded 0 · 0%Very low 12 · 40%Low 10 · 33.3%Moderate 5 · 16.7%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

Show all 3 versions

Summary of findings ‐ 400 mg inhaled mannitol compared with 50 mg inhaled mannitol for cystic fibrosis

Population: adults, children and young people with CF
6 questions
OutcomeEffectEvidenceStatus / GRADE
HRQoL ‐ all domains (change from baseline) Scale: age‐appropriate versions of the CFQ‐R questionnaire
Summary of findings ‐ 400 mg inhaled mannitol vs 50 mg inhaled mannitol
no estimate extracted2 studies · 324 participantsLow
Downgraded: indirectness
Lung function: FEV1 mL (change from baseline)
Summary of findings ‐ 400 mg inhaled mannitol vs 50 mg inhaled mannitol
no estimate extracted2 studies · 600 participantsModerate
Downgraded: indirectness
Lung function: FEV1 % predicted (change from baseline)
Summary of findings ‐ 400 mg inhaled mannitol vs 50 mg inhaled mannitol
no estimate extracted2 studies · 600 participantsModerate
Downgraded: indirectness
Lung function: FVC mL (change from baseline)
Summary of findings ‐ 400 mg inhaled mannitol vs 50 mg inhaled mannitol
no estimate extracted2 studies · 600 participantsModerate
Downgraded: indirectness
Lung function: FEF25-75 mL/s (change from baseline)
Summary of findings ‐ 400 mg inhaled mannitol vs 50 mg inhaled mannitol
no estimate extracted2 studies · 600 participantsModerate
Downgraded: indirectness
Adverse events relating to treatment Scale: mild, moderate, severe and total
Summary of findings ‐ 400 mg inhaled mannitol vs 50 mg inhaled mannitol
no estimate extracted2 studies · 600 participantsModerate
Downgraded: indirectness

Summary of findings ‐ Inhaled mannitol compared with control (non‐respirable mannitol) for cystic fibrosis

Population: adults, children and young people with CF
6 questions
OutcomeEffectEvidenceStatus / GRADE
HRQoL ‐ all domains (change from baseline) Scale: age‐appropriate versions of the CFQ‐R questionnaire
Summary of findings ‐ Inhaled mannitol vs control (non‐respirable mannitol)
no estimate extracted391 participantsVery low
Downgraded: risk of bias, imprecision, indirectness
Lung function: FEV1 mL (absolute change from baseline)
Summary of findings ‐ Inhaled mannitol vs control (non‐respirable mannitol)
no estimate extracted1 study · 391 participantsLow
Downgraded: risk of bias, imprecision, indirectness
Lung function: FEV1 % predicted (change from baseline)
Summary of findings ‐ Inhaled mannitol vs control (non‐respirable mannitol)
no estimate extracted1261 participantsLow
Downgraded: risk of bias, imprecision, indirectness
Lung function: FVC mL or % predicted (change from baseline)
Summary of findings ‐ Inhaled mannitol vs control (non‐respirable mannitol)
no estimate extracted1261 participantsLow
Downgraded: risk of bias, imprecision, indirectness
Lung function: FEF25-75 mL/s or % predicted (change from baseline)
Summary of findings ‐ Inhaled mannitol vs control (non‐respirable mannitol)
no estimate extracted1261 participantsLow
Downgraded: risk of bias, imprecision, indirectness
Adverse events relating to treatment Scale: mild, moderate, severe and total
Summary of findings ‐ Inhaled mannitol vs control (non‐respirable mannitol)
no estimate extracted123 participantsLow
Downgraded: risk of bias, imprecision, indirectness

Summary of findings ‐ Inhaled mannitol compared with control (non‐respirable mannitol) for people with cystic fibrosis, hospitalised due to pulmonary exacerbations

Population: children and young people with CF
6 questions
OutcomeEffectEvidenceStatus / GRADE
HRQoL ‐ change from baseline in CFCS total score and CFQ‐R respiratory domain
Summary of findings ‐ Inhaled mannitol vs control (non‐respirable mannitol)
no estimate extracted1 study · 22 participantsVery low
Downgraded: imprecision, indirectness
Lung function: FEV1 mL% predicted (change from baseline)
Summary of findings ‐ Inhaled mannitol vs control (non‐respirable mannitol)
no estimate extractedNRNo studies
Lung function: FEV1 % predicted (change from baseline)
Summary of findings ‐ Inhaled mannitol vs control (non‐respirable mannitol)
no estimate extracted1 study · 22 participantsLow
Downgraded: imprecision, indirectness
Lung function: FVC % predicted (change from baseline)
Summary of findings ‐ Inhaled mannitol vs control (non‐respirable mannitol)
no estimate extracted1 study · 22 participantsLow
Downgraded: imprecision, indirectness
Lung function: FEF25-75 % predicted (change from baseline)
Summary of findings ‐ Inhaled mannitol vs control (non‐respirable mannitol)
no estimate extracted1 study · 22 participantsLow
Downgraded: imprecision, indirectness
Adverse events relating to treatment
Summary of findings ‐ Inhaled mannitol vs control (non‐respirable mannitol)
no estimate extracted1 study · 22 participantsLow
Downgraded: imprecision, indirectness

Summary of findings ‐ Inhaled mannitol compared with dornase alfa for cystic fibrosis

Population: children and young people with CF
6 questions
OutcomeEffectEvidenceStatus / GRADE
HRQoL ‐ all domains (change from baseline) Scale: age‐appropriate versions of the CFQ‐R questionnaire
Summary of findings ‐ Inhaled mannitol vs dornase alfa
no estimate extracted231 participantsVery low
Downgraded: risk of bias, imprecision, indirectness
Lung function: FEV1 mL (percentage change from baseline)
Summary of findings ‐ Inhaled mannitol vs dornase alfa
MD 2.8231 participantsVery low
Downgraded: risk of bias, imprecision, indirectness
Lung function: FEV1 % predicted
Summary of findings ‐ Inhaled mannitol vs dornase alfa
no estimate extractedNRNo studies
Lung function: FVC mL (percentage change from baseline)
Summary of findings ‐ Inhaled mannitol vs dornase alfa
MD 0.14231 participantsVery low
Downgraded: risk of bias, imprecision, indirectness
Lung function: FEF25-75 mL/s (percentage change from baseline)
Summary of findings ‐ Inhaled mannitol vs dornase alfa
no estimate extracted231 participantsVery low
Downgraded: risk of bias, imprecision, indirectness
Adverse events relating to treatment Scale: mild, moderate, severe and total
Summary of findings ‐ Inhaled mannitol vs dornase alfa
no estimate extracted231 participantsVery low
Downgraded: risk of bias, imprecision, indirectness

Summary of findings ‐ Inhaled mannitol plus dornase alfa compared with dornase alfa for cystic fibrosis

Population: children and young people with cystic fibrosis
6 questions
OutcomeEffectEvidenceStatus / GRADE
HRQoL ‐ all domains (change from baseline) Scale: age‐appropriate versions of the CFQ‐R questionnaire
Summary of findings ‐ Inhaled mannitol plus dornase alfa vs dornase alfa
no estimate extracted231 participantsVery low
Downgraded: risk of bias, imprecision, indirectness
Lung function: FEV1mL (percentage change from baseline)
Summary of findings ‐ Inhaled mannitol plus dornase alfa vs dornase alfa
no estimate extracted231 participantsVery low
Downgraded: risk of bias, imprecision, indirectness
Lung function: FEV1 % predicted
Summary of findings ‐ Inhaled mannitol plus dornase alfa vs dornase alfa
no estimate extractedNRNo studies
Lung function: FVC mL (percentage change from baseline)
Summary of findings ‐ Inhaled mannitol plus dornase alfa vs dornase alfa
no estimate extracted231 participantsVery low
Downgraded: risk of bias, imprecision, indirectness
Lung function: FEF25-75 mL/s (percentage change from baseline)
Summary of findings ‐ Inhaled mannitol plus dornase alfa vs dornase alfa
no estimate extracted231 participantsVery low
Downgraded: risk of bias, imprecision, indirectness
Adverse events relating to treatment Scale: mild, moderate, severe and total
Summary of findings ‐ Inhaled mannitol plus dornase alfa vs dornase alfa
no estimate extracted231 participantsVery low
Downgraded: risk of bias, imprecision, indirectness