Summary of findings 3. MgSO4 compared to SABA in the treatment of acute asthma.
MgSO₄compared to SABA in the treatment of acute asthma | ||||||
Patient or population: adults and children with acute exacerbation of asthma Setting: emergency department/inpatient Intervention: MgSO₄ Comparison: SABA | ||||||
Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Quality of the evidence (GRADE) | Comments | |
Risk with SABA | Risk with MgSO4 | |||||
Lung function | Reported narratively in text | |||||
Clinical severity score ‐ Fischl index (120 minutes) |
The Fischl index score was 2.1 | Fischl index score 0.13 lower (0.62 lower to 0.36 higher) | ‐ | 93 (3 RCTs) | ⊕⊝⊝⊝ VERY LOW 1 2 3 | Time point 120 minutes in 2 studies and unclear in the third study Wide range of control group scores (0.3, 0.76 and 4.81). Scale out of 7 with higher score indicating more severe symptoms. 4.81 reported in study with unclear time point. |
Admission to hospital at initial presentation | 118 per 1000 | 62 per 1000 (6 to 625) | RR 0.53 (0.05 to 5.31) | 33 (1 RCT) | ⊕⊝⊝⊝ VERY LOW 4 5 | |
Serious adverse events (During ED/hospital admission) |
Not estimable | Not estimable. See comment | 53 (2 RCTs) | ⊕⊕⊝⊝ LOW 1 6 | Risk difference: 0.00 (95% CI −0.10 to 0.10) No events reported |
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*The risk in the intervention group (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; OR: Odds ratio; | ||||||
GRADE Working Group grades of evidence High quality: We are very confident that the true effect lies close to that of the estimate of the effect Moderate quality: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low quality: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low quality: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect |
1 Several studies at unclear or high risk of bias in one or more domains (−1 study limitations)
2 Confidence intervals include both possible harm and benefit of the intervention (−1 imprecision)
3 Time‐point for measurement unclear in one study (−1 indirectness)
4 Study at unclear risk of bias in several domains (−1 study limitations)
5 One small study. Confidence intervals include appreciable harm or benefit of the intervention (−2 imprecision)
6 Two small studies. No events reported. Risk difference confidence intervals include appreciable harm or benefit of the intervention (−1 for imprecision)