Summary of findings 2. Single inhaler therapy compared to fixed dose ICS for asthma in adults not controlled on regular ICS.
| Single inhaler therapy compared to fixed dose ICS for asthma in adults not controlled on regular ICS | ||||||
| Patient or population: patients with asthma in adults not controlled on regular ICS Settings: community Intervention: Single inhaler therapy Comparison: fixed dose ICS | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Fixed dose ICS | Single inhaler therapy | |||||
| Patients with exacerbations causing hospitalisation Follow‐up: mean 11 months | 10 per 1000 | 6 per 1000 (3 to 11) | OR 0.56 (0.28 to 1.09) | 4209 (3 studies) | ⊕⊕⊕⊝ moderate1 | |
| Patients with exacerbations treated with oral steroids Follow‐up: mean 11 months | 181 per 1000 | 107 per 1000 (90 to 124) | OR 0.54 (0.45 to 0.64) | 4280 (4 studies) | ⊕⊕⊕⊕ high | |
| Fatal serious adverse events Follow‐up: mean 11 months | 1 per 1000 | 1 per 1000 (0 to 4) | OR 0.37 (0.05 to 2.62) | 4209 (3 studies) | ⊕⊕⊕⊝ moderate1 | |
| Serious adverse events (non‐fatal) Follow‐up: mean 11 months | 48 per 1000 | 47 per 1000 (36 to 62) | OR 0.97 (0.73 to 1.29) | 4209 (3 studies) | ⊕⊕⊕⊝ moderate1 | |
| Discontinuation due to adverse events Follow‐up: mean 11 months | 36 per 1000 | 21 per 1000 (13 to 33) | OR 0.57 (0.35 to 0.93) | 2586 (2 studies) | ⊕⊕⊕⊕ high | |
| *The basis for the assumed risk is the mean control group risk across studies. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; OR: Odds ratio; | ||||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | ||||||
1 Confidence interval cannot rule out important differences in either direction ICS: inhaled corticosteroids