Summary of findings for the main comparison. Ciclesonide versus budesonide (dose ratio 1:2) for chronic asthma in children.
| Ciclesonide versus budesonide (dose ratio 1:2) for chronic asthma in children | ||||||
| Patient or population: patients with chronic asthma in children Settings: all settings Intervention: ciclesonide Comparison: budesonide (dose ratio 1:2) | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Budesonide (dose ratio 1:2) | Ciclesonide | |||||
| Asthma symptoms Asthma symptom score (scale 0 to 4) Follow‐up: 12 weeks | See comment | See comment | Not estimable | 1024 (2 studies) | ⊕⊕⊝⊝ low1,2 | Both studies used a 5‐point scale, but insufficient data were reported to allow meta‐analysis |
| Patients with exacerbations Number of patients with exacerbations Follow‐up: 12 weeks | 12 per 1000 | 26 per 1000 (9 to 77) | RR 2.2 (0.75 to 6.43) | 1024 (2 studies) | ⊕⊝⊝⊝ very low1,2,3,4 | |
| Adverse events Number of patients with adverse events Follow‐up: 12 weeks | See comment | See comment | Not estimable | 1024 (2 studies) | ⊕⊕⊝⊝ low1,2,3 | The data could not be meta‐analysed because the definitions of adverse events were too diverse |
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. 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; RR: risk 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 In one study the dose of budesonide was much higher than what is commonly prescribed in clinical practice. 2 Both studies were sponsored by the manufacturer and at least one of the authors of each study was an employee of the manufacturer that sponsored the study. 3 The intervention period of 12 weeks was too short to expect any major changes in this outcome. 4 Confidence intervals of estimated effect include no effect and exceed a relative reduction or increase risk of 25%.