5. Outcomes in Cochrane reviews ‐ lung function.
| Intervention/comparison | Outcome | Number of participants (number of studies) | Results: treatment effect (95% CI) unless otherwise stated | Interpretation of result1 | Evaluation1 |
| Pharmacological interventions | |||||
| Antibiotics (long term) vs. placebo (Evans 2007) |
FEV1 % predicted at end of trial | 27 (1, children) 17 (1, adults) |
MD ‐1.05% (‐6.93 to 4.83), P value = 0.7 | NSD | No evidence of benefit |
| FEV1 (unit not reported) | 59 (3) | Not pooled but all reported no difference (values not reported) | NSD | No evidence of benefit | |
| Antibiotics (short term) vs. placebo (Wurzel 2011) |
Tobramycin vs. placebo: FEV1 % predicted change from baseline | 74 (1, adults) | MD and CI not reported, tobramycin ‐2.2%; placebo 1.5%, P value = 0.41 | NSD | No evidence of benefit |
| ICS vs. placebo/no treatment (Kapur 2009) |
Short‐term follow‐up < 6 months: FEV1 L change from baseline | 101 (3, adults) | MD 0.09 L (0.03 to 0.15), P value = 0.002 Effect based on 1 study without placebo comparison |
Statistically significant difference | Evidence of statistical benefit |
| LABA/ICS combination vs. ICS (Goyal 2014) |
FEV1 mL change from baseline | 40 (1) | MD ‐14.00 mL (‐84.14 to 56.14), P value not reported | NSD | No evidence of benefit |
| Inhaled hyperosmolar vs. placebo or ITS (Hart 2014) |
Mannitol vs. placebo: FEV1 % predicted change from baseline | 17 (1) | MD 2.70% (‐8.53 to 13.93), P value not reported | NSD | No evidence of benefit |
|
Mannitol vs. placebo FEV1 L: at end of trial |
343 (1) | MD 0.03 L (‐0.10 to 0.16), P value not reported | NSD | No evidence of benefit | |
| Mannitol vs. placebo FEV1: change (unit not reported) | 12 (1) | Not reported | NSD | No evidence of benefit | |
| HTS vs. ITS: FEV1 % predicted change from baseline | 30 (1) | MD 13.30% (CI not reported), P value < 0.01 Favoured HTS |
Statistically significant difference | Evidence of clinically relevant benefit | |
| HTS vs. ITS: FEV1 L at end of trial | 40 (1) | MD 0.19 L (‐0.37 to 0.75), P value = 0.5 | NSD | No evidence of benefit | |
| Mucolytics vs. placebo (Wilkinson 2014) |
Bromhexine vs. placebo: FEV1 mL at end of trial | 88 (1) | MD 184.00 mL (‐149.75 to 517.75), P value not reported | NSD | No evidence of benefit |
| RhDNase 5 mg vs. placebo: FEV1 L % change from baseline | 40 (1) | MD 2.10% (‐2.90 to 7.10), P value not reported | NSD | No evidence of benefit | |
| RhDNase 2.5 mg vs. placebo: FEV1 L % change from baseline | 237 (2) | n = 197, MD ‐1.9% decline, P value < 0.05, favoured placebo; n = 40, MD 2.10% (‐4.05 to ‐8.25), P value not reported |
Statistically significant difference (1 trial) NSD (1 trial) |
Unclear | |
| Erdosteine vs. nothing: FEV1 mL change from baseline | 30 (1) | MD 200 mL (40 to 360), P value not reported | Statistically significant difference | Evidence of clinically relevant benefit | |
| Erdosteine vs. nothing: FEV1 % predicted change from baseline | 30 (1) | MD 4.50% (‐3.11 to 12.11), P value not reported | NSD | No evidence of benefit | |
| Non‐pharmacological interventions | |||||
| Physical therapy: IMT vs. no intervention or sham treatment (Bradley 2002) |
Outcome not reported in trial | ||||
| Nurse‐led vs. doctor‐led care (French 2003) |
FEV1 % predicted at end of trial | 80 (1) | MD 2.37 (‐7.37 to 12.11), P value not reported | NSD | No evidence of benefit |
| ACTs vs no treatment (Lee 2013) |
FEV1 L at end of trial | 38 (3, adults) | Median difference 0.0 L, P value = 0.7 (1 study, no values for other 2 studies) | NSD | No evidence of benefit |
| FEV1 (unit not reported) at end of trial | 9 (1, children) | Difference 8.86% (values not reported), P value not reported, favoured ACT | Statistically significant difference | Unclear | |
1. No minimum clinically important difference for FEV1 in bronchiectasis. Reference values from American Thoracic Society/European Respiratory Society recommendations as follows: change of at least 100 mL or change of ≥ 20% in short‐term trials (of weeks of duration) and ≥ 15% in long‐term trials (≥ 1 year) (Pellegrino 2005).
Abbreviations: ACT: airway clearance technique; CI: confidence interval; FEV1: forced expiratory volume in 1 second; HTS: hypertonic saline; ICS: inhaled corticosteroids; IMT: inspiratory muscle training; ITS: isotonic saline; LABA: long‐acting beta2‐agonist; n: number of participants; MD: mean difference; NSD: no statistically significant difference; RhDNase: recombinant human deoxyribonuclease I; vs: versus.