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. 2018 May 16;2018(5):CD000996. doi: 10.1002/14651858.CD000996.pub3

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
 
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
 
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
 
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
 
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
 
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
 
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
 
*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 evidenceHigh‐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.