Summary of findings for the main comparison. Inhaled corticosteroids compared to placebo for bronchiectasis (short‐term use of 6 months or less).
Inhaled corticosteroids compared to placebo for bronchiectasis (< 6 months) | ||||||
Patient or population: people with bronchiectasis Setting: university hospital Intervention: inhaled corticosteroids Comparison: placebo | ||||||
Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
Risk with placebo | Risk with Inhaled corticosteroids | |||||
Lung function (spirometry indices) ‐ FEV1 (in L, end study minus baseline values) | Mean change from baseline ranged from ‐0.038 to 0.805 | MD 0.09 lower (0.26 lower to 0.09 higher) | ‐ | 156 (2 studies) | ⊕⊕⊝⊝ Low1,2,3 |
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Lung function (spirometry indices) ‐ FVC (in L, end study minus baseline values) | Mean change from baseline ranged from ‐0.062 to 0.0218 | MD 0.01 higher (0.16 lower to 0.17 higher) | ‐ | 156 (2 studies) | ⊕⊕⊝⊝ Low1,2,3 |
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Lung function (other indices) ‐ diffusion capacity % predicted (end of study) | Mean end of study value 84.2 | MD 2.70 higher (2.49 lower to 7.89 higher) | ‐ | 57 (1 study) | ⊕⊕⊝⊝ Low1,2,3 |
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Lung function (other indices) ‐ RV % predicted (end of study values) | Mean end of study value 106 | MD 2.00 higher (9.41 lower to 13.41 higher) | ‐ | 57 (1 study) | ⊕⊕⊝⊝ Low1,2,3 |
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Lung function (other indices) ‐ TLC % predicted (end of study values) | Mean end of study value 86.4 | MD 3.20 higher (1.99 lower to 8.39 higher) | ‐ | 57 (1 study) | ⊕⊕⊝⊝ Low1,2,3 |
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Average number of exacerbations per participant | Average number of exacerbations per patient ranged from 0.97 to 1.31 | MD 0.17 lower (0.56 lower to 0.22 higher) | ‐ | 127 (2 studies) | ⊕⊕⊝⊝ Low1,2,3 |
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Pseudomonas aeruginosa (P aeruginosa) colonisation | 410 per 1000 | 395 per 1000 (238 to 576) | OR 0.94 (0.45 to 1.96) | 156 (2 studies) | ⊕⊕⊝⊝ Low1,2,3 |
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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; FEV1: forced expiratory volume in 1 second; FVC: forced vital capacity; MD: mean difference; OR: odds ratio; RV: residual volume; TLC: total lung capacity | ||||||
GRADE Working Group grades of evidence High‐certainty: we are very confident that the true effect lies close to that of the estimate of the effect Moderate‐certainty: 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‐certainty: our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low‐certainty: we have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect |
1The largest study was not a placebo controlled trial (Martinez‐Garcia 2006). 2Study participant numbers are small; outcome downgraded one point for imprecision. 3One study had an issue with directness (Joshi 2004), but did not contribute to this outcome.