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. 2023 Jun 14;2023(6):CD001506. doi: 10.1002/14651858.CD001506.pub5

Comparison 1. Hypertonic saline 3% to 7% versus isotonic saline.

Outcome or subgroup title No. of studies No. of participants Statistical method Effect size
1.1 Change in FEV1 (% predicted) 5   Mean Difference (IV, Fixed, 95% CI) Subtotals only
1.1.1 At 2 to 4 weeks (all participants) 4 246 Mean Difference (IV, Fixed, 95% CI) 3.30 [0.71, 5.89]
1.1.2 At 2 to 4 weeks (participants aged 14 years and over) 2 205 Mean Difference (IV, Fixed, 95% CI) 4.15 [1.14, 7.16]
1.1.3 At 2 to 4 weeks (children FEV1 > 80% predicted) 1 20 Mean Difference (IV, Fixed, 95% CI) ‐0.42 [‐7.45, 6.61]
1.1.4 At 12 weeks 1 149 Mean Difference (IV, Fixed, 95% CI) 4.10 [‐0.08, 8.28]
1.1.5 At 24 weeks 1 140 Mean Difference (IV, Fixed, 95% CI) 5.37 [1.03, 9.71]
1.1.6 At 36 weeks 1 134 Mean Difference (IV, Fixed, 95% CI) 3.63 [‐1.56, 8.82]
1.1.7 At 48 weeks 1 134 Mean Difference (IV, Fixed, 95% CI) 2.31 [‐2.72, 7.34]
1.1.8 24 hours after single dose 1 36 Mean Difference (IV, Fixed, 95% CI) 0.30 [‐3.48, 4.08]
1.2 Change in FVC (% predicted) 3   Mean Difference (IV, Fixed, 95% CI) Subtotals only
1.2.1 At 2 to 4 weeks 3 225 Mean Difference (IV, Fixed, 95% CI) 1.07 [‐1.63, 3.78]
1.2.2 At 12 weeks 1 141 Mean Difference (IV, Fixed, 95% CI) 4.56 [0.79, 8.33]
1.2.3 At 24 weeks 1 140 Mean Difference (IV, Fixed, 95% CI) 3.64 [0.17, 7.11]
1.2.4 At 36 weeks 1 134 Mean Difference (IV, Fixed, 95% CI) 3.40 [‐0.82, 7.62]
1.2.5 At 48 weeks 1 134 Mean Difference (IV, Fixed, 95% CI) 2.76 [‐1.09, 6.61]
1.3 Mean change in FEV0.5 (mL) 1   Mean Difference (IV, Fixed, 95% CI) Totals not selected
1.3.1 At 48 weeks 1   Mean Difference (IV, Fixed, 95% CI) Totals not selected
1.4 Mean change in FEV0.75 (L) 1   Mean Difference (IV, Fixed, 95% CI) Subtotals only
1.4.1 12 weeks 1 150 Mean Difference (IV, Fixed, 95% CI) 0.02 [‐0.03, 0.07]
1.4.2 24 weeks 1 150 Mean Difference (IV, Fixed, 95% CI) 0.02 [‐0.04, 0.08]
1.4.3 36 weeks 1 150 Mean Difference (IV, Fixed, 95% CI) 0.04 [‐0.01, 0.09]
1.4.4 48 weeks 1 150 Mean Difference (IV, Fixed, 95% CI) 0.01 [‐0.04, 0.06]
1.5 LCI 1   Mean Difference (IV, Fixed, 95% CI) Totals not selected
1.5.1 At 4 weeks 1   Mean Difference (IV, Fixed, 95% CI) Totals not selected
1.6 LCI change from baseline 2 190 Mean Difference (IV, Fixed, 95% CI) ‐0.60 [‐1.00, ‐0.19]
1.6.1 At 12 months 2 190 Mean Difference (IV, Fixed, 95% CI) ‐0.60 [‐1.00, ‐0.19]
1.7 Radiolabelled isotope clearance (%) 3   Mean Difference (IV, Fixed, 95% CI) Subtotals only
1.7.1 At 60 mins 3 68 Mean Difference (IV, Fixed, 95% CI) 6.14 [2.56, 9.72]
1.8 Mucociliary clearance measured as area under the curve 2   Mean Difference (IV, Fixed, 95% CI) Subtotals only
1.8.1 Single dose 2 44 Mean Difference (IV, Fixed, 95% CI) ‐212.06 [‐271.64, ‐152.48]
1.9 Change in mucocilliary clearance rate (% clearance) 1   Mean Difference (IV, Fixed, 95% CI) Totals not selected
1.9.1 At 4 weeks 1   Mean Difference (IV, Fixed, 95% CI) Totals not selected
1.10 Exercise capacity (using a subjective visual analogue score) 1   Mean Difference (IV, Fixed, 95% CI) Subtotals only
1.10.1 At Week 1 1 52 Mean Difference (IV, Fixed, 95% CI) 0.88 [0.19, 1.57]
1.10.2 At Week 2 1 52 Mean Difference (IV, Fixed, 95% CI) 1.01 [0.18, 1.84]
1.11 Quality of life (change from baseline) 4   Mean Difference (IV, Fixed, 95% CI) Subtotals only
1.11.1 CFQ parent 3 365 Mean Difference (IV, Fixed, 95% CI) 1.62 [‐1.69, 4.92]
1.11.2 CFQ 14+ 1 91 Mean Difference (IV, Fixed, 95% CI) 7.77 [1.86, 13.68]
1.11.3 SF36 1 91 Mean Difference (IV, Fixed, 95% CI) 2.84 [‐7.90, 13.58]
1.11.4 CFQ‐R respiratory domain at 4 weeks 1 20 Mean Difference (IV, Fixed, 95% CI) 7.40 [‐2.45, 17.25]
1.12 Feeling of cleared chest (using a subjective visual analogue scale) 2   Mean Difference (IV, Fixed, 95% CI) Subtotals only
1.12.1 At up to Week 1 2 72 Mean Difference (IV, Fixed, 95% CI) 0.97 [0.35, 1.60]
1.13 Average number of pulmonary exacerbations 2   Mean Difference (IV, Fixed, 95% CI) Totals not selected
1.13.1 Number requiring antibiotics 2   Mean Difference (IV, Fixed, 95% CI) Totals not selected
1.13.2 Number of visits not requiring antibiotics 1   Mean Difference (IV, Fixed, 95% CI) Totals not selected
1.14 Average number of hospital admissions per participant 1   Mean Difference (IV, Fixed, 95% CI) Totals not selected
1.14.1 At 48 weeks 1   Mean Difference (IV, Fixed, 95% CI) Totals not selected
1.15 Mean adherence rate 1   Mean Difference (IV, Fixed, 95% CI) Subtotals only
1.16 Change in log10 colony forming units (CFU)/g from baseline at final visit 1   Mean Difference (IV, Fixed, 95% CI) Totals not selected
1.16.1 P. aeruginosa 1   Mean Difference (IV, Fixed, 95% CI) Totals not selected
1.16.2 S. aureus 1   Mean Difference (IV, Fixed, 95% CI) Totals not selected
1.17 Mean time (years) to first detection of CF pathogens 1   Mean Difference (IV, Fixed, 95% CI) Totals not selected
1.17.1 First detection of S aureus 1   Mean Difference (IV, Fixed, 95% CI) Totals not selected
1.17.2 First detection of H influenzae 1   Mean Difference (IV, Fixed, 95% CI) Totals not selected
1.17.3 First isolation of P aeruginosa 1   Mean Difference (IV, Fixed, 95% CI) Totals not selected
1.18 Adverse events: acute fall in lung function 2   Mean Difference (IV, Fixed, 95% CI) Totals not selected
1.18.1 Acute fall in FEV₁ % predicted 1   Mean Difference (IV, Fixed, 95% CI) Totals not selected
1.18.2 Acute fall in FEV₁ mL 1   Mean Difference (IV, Fixed, 95% CI) Totals not selected
1.19 Adverse events 2 to 4 weeks 2   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
1.19.1 Any adverse event 1 23 Risk Ratio (M‐H, Fixed, 95% CI) 0.81 [0.59, 1.10]
1.19.2 Cough 2 75 Risk Ratio (M‐H, Fixed, 95% CI) 0.80 [0.41, 1.58]
1.19.3 Pharyngitis 2 75 Risk Ratio (M‐H, Fixed, 95% CI) 3.08 [0.36, 26.35]
1.19.4 Chest tightness 1 52 Risk Ratio (M‐H, Fixed, 95% CI) 2.79 [0.12, 65.38]
1.19.5 Haemoptysis 1 52 Risk Ratio (M‐H, Fixed, 95% CI) 0.93 [0.21, 4.17]
1.19.6 Wheezing 1 23 Risk Ratio (M‐H, Fixed, 95% CI) 0.22 [0.01, 4.93]
1.19.7 Nasal congestion 1 23 Risk Ratio (M‐H, Fixed, 95% CI) 0.43 [0.09, 2.08]
1.19.8 Increased sputum production 1 33 Risk Ratio (M‐H, Fixed, 95% CI) 1.36 [0.09, 19.88]
1.20 Adverse events 48 to 52 weeks 3   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
1.20.1 All adverse events 2 192 Risk Ratio (M‐H, Fixed, 95% CI) 1.00 [0.92, 1.09]
1.20.2 Serious adverse events 2 192 Risk Ratio (M‐H, Fixed, 95% CI) 0.85 [0.42, 1.69]
1.20.3 Cough 3 513 Risk Ratio (M‐H, Fixed, 95% CI) 1.02 [0.87, 1.19]
1.20.4 Chest tightness 1 321 Risk Ratio (M‐H, Fixed, 95% CI) 0.21 [0.01, 4.26]
1.20.5 Vomiting 1 321 Risk Ratio (M‐H, Fixed, 95% CI) 0.52 [0.13, 2.03]
1.20.6 Wheezing 1 321 Risk Ratio (M‐H, Fixed, 95% CI) 2.06 [0.38, 11.11]
1.20.7 Fever 3 513 Risk Ratio (M‐H, Fixed, 95% CI) 0.73 [0.53, 1.00]
1.20.8 Nasal congestion 2 471 Risk Ratio (M‐H, Fixed, 95% CI) 0.90 [0.63, 1.27]
1.20.9 Ear infection 2 363 Risk Ratio (M‐H, Fixed, 95% CI) 1.27 [0.74, 2.17]
1.20.10 Acquisition of Burkholderia cepacia 1 321 Risk Ratio (M‐H, Fixed, 95% CI) 1.03 [0.15, 7.23]
1.20.11 Abdominal distension / flatulence 1 42 Risk Ratio (M‐H, Fixed, 95% CI) 2.00 [0.71, 5.64]
1.20.12 Rhinorrhoea 1 42 Risk Ratio (M‐H, Fixed, 95% CI) 1.70 [1.04, 2.79]
1.20.13 Diarrhoea 1 42 Risk Ratio (M‐H, Fixed, 95% CI) 0.83 [0.30, 2.31]