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
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
Current version onlySummary of findings ‐ 400 mg inhaled mannitol compared with 50 mg inhaled mannitol for cystic fibrosis
Population: adults, children and young people with CF
| Outcome | Effect | Evidence | Status / 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 extracted | 2 studies · 324 participants | Low Downgraded: indirectness |
Lung function: FEV1 mL (change from baseline) Summary of findings ‐ 400 mg inhaled mannitol vs 50 mg inhaled mannitol | no estimate extracted | 2 studies · 600 participants | Moderate Downgraded: indirectness |
Lung function: FEV1 % predicted (change from baseline) Summary of findings ‐ 400 mg inhaled mannitol vs 50 mg inhaled mannitol | no estimate extracted | 2 studies · 600 participants | Moderate Downgraded: indirectness |
Lung function: FVC mL (change from baseline) Summary of findings ‐ 400 mg inhaled mannitol vs 50 mg inhaled mannitol | no estimate extracted | 2 studies · 600 participants | Moderate 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 extracted | 2 studies · 600 participants | Moderate 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 extracted | 2 studies · 600 participants | Moderate Downgraded: indirectness |
Summary of findings ‐ Inhaled mannitol compared with control (non‐respirable mannitol) for cystic fibrosis
Population: adults, children and young people with CF
| Outcome | Effect | Evidence | Status / 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 extracted | 391 participants | Very 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 extracted | 1 study · 391 participants | Low 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 extracted | 1261 participants | Low 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 extracted | 1261 participants | Low 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 extracted | 1261 participants | Low 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 extracted | 123 participants | Low 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
| Outcome | Effect | Evidence | Status / 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 extracted | 1 study · 22 participants | Very low Downgraded: imprecision, indirectness |
Lung function: FEV1 mL% predicted (change from baseline) Summary of findings ‐ Inhaled mannitol vs control (non‐respirable mannitol) | no estimate extracted | NR | No studies |
Lung function: FEV1 % predicted (change from baseline) Summary of findings ‐ Inhaled mannitol vs control (non‐respirable mannitol) | no estimate extracted | 1 study · 22 participants | Low Downgraded: imprecision, indirectness |
Lung function: FVC % predicted (change from baseline) Summary of findings ‐ Inhaled mannitol vs control (non‐respirable mannitol) | no estimate extracted | 1 study · 22 participants | Low Downgraded: imprecision, indirectness |
Lung function: FEF25-75 % predicted (change from baseline) Summary of findings ‐ Inhaled mannitol vs control (non‐respirable mannitol) | no estimate extracted | 1 study · 22 participants | Low Downgraded: imprecision, indirectness |
Adverse events relating to treatment Summary of findings ‐ Inhaled mannitol vs control (non‐respirable mannitol) | no estimate extracted | 1 study · 22 participants | Low Downgraded: imprecision, indirectness |
Summary of findings ‐ Inhaled mannitol compared with dornase alfa for cystic fibrosis
Population: children and young people with CF
| Outcome | Effect | Evidence | Status / 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 extracted | 231 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Lung function: FEV1 mL (percentage change from baseline) Summary of findings ‐ Inhaled mannitol vs dornase alfa | MD 2.8 | 231 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Lung function: FEV1 % predicted Summary of findings ‐ Inhaled mannitol vs dornase alfa | no estimate extracted | NR | No studies |
Lung function: FVC mL (percentage change from baseline) Summary of findings ‐ Inhaled mannitol vs dornase alfa | MD 0.14 | 231 participants | Very 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 extracted | 231 participants | Very 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 extracted | 231 participants | Very 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
| Outcome | Effect | Evidence | Status / 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 extracted | 231 participants | Very 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 extracted | 231 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Lung function: FEV1 % predicted Summary of findings ‐ Inhaled mannitol plus dornase alfa vs dornase alfa | no estimate extracted | NR | No studies |
Lung function: FVC mL (percentage change from baseline) Summary of findings ‐ Inhaled mannitol plus dornase alfa vs dornase alfa | no estimate extracted | 231 participants | Very 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 extracted | 231 participants | Very 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 extracted | 231 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Summary of findings ‐ 400 mg inhaled mannitol compared with 50 mg inhaled mannitol for cystic fibrosis
Population: adults, children and young people with CF
| Outcome | Effect | Evidence | Status / 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 extracted | 2 studies · 324 participants | Low Downgraded: indirectness |
Lung function: FEV1 mL (change from baseline) Summary of findings ‐ 400 mg inhaled mannitol vs 50 mg inhaled mannitol | no estimate extracted | 2 studies · 600 participants | Moderate Downgraded: indirectness |
Lung function: FEV1 % predicted (change from baseline) Summary of findings ‐ 400 mg inhaled mannitol vs 50 mg inhaled mannitol | no estimate extracted | 2 studies · 600 participants | Moderate Downgraded: indirectness |
Lung function: FVC mL (change from baseline) Summary of findings ‐ 400 mg inhaled mannitol vs 50 mg inhaled mannitol | no estimate extracted | 2 studies · 600 participants | Moderate 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 extracted | 2 studies · 600 participants | Moderate 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 extracted | 2 studies · 600 participants | Moderate Downgraded: indirectness |
Summary of findings ‐ Inhaled mannitol compared with control (non‐respirable mannitol) for cystic fibrosis
Population: adults, children and young people with CF
| Outcome | Effect | Evidence | Status / 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 extracted | 391 participants | Very 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 extracted | 1 study · 391 participants | Low 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 extracted | 1261 participants | Low 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 extracted | 1261 participants | Low 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 extracted | 1261 participants | Low 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 extracted | 123 participants | Low 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
| Outcome | Effect | Evidence | Status / 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 extracted | 1 study · 22 participants | Very low Downgraded: imprecision, indirectness |
Lung function: FEV1 mL% predicted (change from baseline) Summary of findings ‐ Inhaled mannitol vs control (non‐respirable mannitol) | no estimate extracted | NR | No studies |
Lung function: FEV1 % predicted (change from baseline) Summary of findings ‐ Inhaled mannitol vs control (non‐respirable mannitol) | no estimate extracted | 1 study · 22 participants | Low Downgraded: imprecision, indirectness |
Lung function: FVC % predicted (change from baseline) Summary of findings ‐ Inhaled mannitol vs control (non‐respirable mannitol) | no estimate extracted | 1 study · 22 participants | Low Downgraded: imprecision, indirectness |
Lung function: FEF25‐75 % predicted (change from baseline) Summary of findings ‐ Inhaled mannitol vs control (non‐respirable mannitol) | no estimate extracted | 1 study · 22 participants | Low Downgraded: imprecision, indirectness |
Adverse events relating to treatment Summary of findings ‐ Inhaled mannitol vs control (non‐respirable mannitol) | no estimate extracted | 1 study · 22 participants | Low Downgraded: imprecision, indirectness |
Summary of findings ‐ Inhaled mannitol compared with dornase alfa for cystic fibrosis
Population: children and young people with CF
| Outcome | Effect | Evidence | Status / 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 extracted | 231 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Lung function: FEV1 mL (percentage change from baseline) Summary of findings ‐ Inhaled mannitol vs dornase alfa | MD 2.8 | 231 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Lung function: FEV1 % predicted Summary of findings ‐ Inhaled mannitol vs dornase alfa | no estimate extracted | NR | No studies |
Lung function: FVC mL (percentage change from baseline) Summary of findings ‐ Inhaled mannitol vs dornase alfa | MD 0.14 | 231 participants | Very 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 extracted | 231 participants | Very 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 extracted | 231 participants | Very 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
| Outcome | Effect | Evidence | Status / 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 extracted | 231 participants | Very 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 extracted | 231 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Lung function: FEV1 % predicted Summary of findings ‐ Inhaled mannitol plus dornase alfa vs dornase alfa | no estimate extracted | NR | No studies |
Lung function: FVC mL (percentage change from baseline) Summary of findings ‐ Inhaled mannitol plus dornase alfa vs dornase alfa | no estimate extracted | 231 participants | Very 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 extracted | 231 participants | Very 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 extracted | 231 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Summary of findings ‐ 400 mg inhaled mannitol compared with 50 mg inhaled mannitol for cystic fibrosis
Population: adults and children with CF
| Outcome | Effect | Evidence | Status / 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 extracted | 2 studies · 324 participants | Low Downgraded: indirectness |
Lung function: FEV1 mL (change from baseline) Summary of findings ‐ 400 mg inhaled mannitol vs 50 mg inhaled mannitol | no estimate extracted | 2 studies · 600 participants | Moderate Downgraded: indirectness |
Lung function: FEV1 % predicted (change from baseline) Summary of findings ‐ 400 mg inhaled mannitol vs 50 mg inhaled mannitol | no estimate extracted | 2 studies · 600 participants | Moderate Downgraded: indirectness |
Lung function: FVC mL (change from baseline) Summary of findings ‐ 400 mg inhaled mannitol vs 50 mg inhaled mannitol | no estimate extracted | 2 studies · 600 participants | Moderate 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 extracted | 2 studies · 600 participants | Moderate 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 extracted | 2 studies · 600 participants | Moderate Downgraded: indirectness |
Summary of findings ‐ Inhaled mannitol compared with control (non‐respirable mannitol) for cystic fibrosis
Population: adults and children with CF
| Outcome | Effect | Evidence | Status / 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 extracted | 1 study · 391 participants | Very low Downgraded: indirectness |
Lung function: FEV1 mL (change from baseline) Summary of findings ‐ Inhaled mannitol vs control (non‐respirable mannitol) | no estimate extracted | 1 study · 391 participants | Low Downgraded: indirectness |
Lung function: FEV1 % predicted (change from baseline) Summary of findings ‐ Inhaled mannitol vs control (non‐respirable mannitol) | no estimate extracted | 1 study · 391 participants | Low Downgraded: indirectness |
Lung function: FVC mL (change from baseline) Summary of findings ‐ Inhaled mannitol vs control (non‐respirable mannitol) | no estimate extracted | 1 study · 391 participants | Low Downgraded: indirectness |
Lung function: FEF25‐75 mL/s (change from baseline) Summary of findings ‐ Inhaled mannitol vs control (non‐respirable mannitol) | no estimate extracted | 1 study · 391 participants | Low Downgraded: indirectness |
Adverse events relating to treatment Scale: Mild, moderate, severe and total Summary of findings ‐ Inhaled mannitol vs control (non‐respirable mannitol) | no estimate extracted | 1 study · 36 participants | Low Downgraded: indirectness |
Summary of findings ‐ Inhaled mannitol compared with dornase alfa for cystic fibrosis
Population: children with CF
| Outcome | Effect | Evidence | Status / 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 extracted | 1 study · 231 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Lung function: FEV1 mL (percentage change from baseline) Summary of findings ‐ Inhaled mannitol vs dornase alfa | MD 2.8 | 1 study · 231 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Lung function: FVC mL (percentage change from baseline) Summary of findings ‐ Inhaled mannitol vs dornase alfa | MD 0.14 | 1 study · 231 participants | Very 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 extracted | 1 study · 231 participants | Very 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 extracted | 1 study · 231 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Summary of findings ‐ Inhaled mannitol plus dornase alfa compared with dornase alfa for cystic fibrosis
Population: children with cystic fibrosis
| Outcome | Effect | Evidence | Status / 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 extracted | 1 study · 231 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Lung function: FEV1 mL (percentage change from baseline) Summary of findings ‐ Inhaled mannitol plus dornase alfa vs dornase alfa | no estimate extracted | 1 study · 231 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Lung function: FVC mL (percentage change from baseline) Summary of findings ‐ Inhaled mannitol plus dornase alfa vs dornase alfa | no estimate extracted | 1 study · 231 participants | Very 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 extracted | 1 study · 231 participants | Very 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 extracted | 1 study · 231 participants | Very low Downgraded: risk of bias, imprecision, indirectness |