Scolaris Content Display Scolaris Content Display

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
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Figure 1

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

Forest plot of comparison: 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), outcome: 1.1 Patients with at least one exacerbation requiring systemic steroids.
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Figure 2

Forest plot of comparison: 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), outcome: 1.1 Patients with at least one exacerbation requiring systemic steroids.

In the control group (on ICS) 7 people out of 100 had at least one exacerbation requiring systemic steroids over 4 to 52 weeks, compared to 10 (95% CI 8 to 13) out of 100 for the active treatment group given LRTA.
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Figure 3

In the control group (on ICS) 7 people out of 100 had at least one exacerbation requiring systemic steroids over 4 to 52 weeks, compared to 10 (95% CI 8 to 13) out of 100 for the active treatment group given LRTA.

Funnel plot of comparison: 1 Anti‐leukotriene (AL) versus. Inhaled glucocorticoids (in HFC‐BDP equivalent), outcome: Patients with at least 1 exacerbation requiring systemic corticosteroids.
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Figure 4

Funnel plot of comparison: 1 Anti‐leukotriene (AL) versus. Inhaled glucocorticoids (in HFC‐BDP equivalent), outcome: Patients with at least 1 exacerbation requiring systemic corticosteroids.

In the control group (on ICS) 2 people out of 100 had withdrawal due to poor control over 4 to 52 weeks, compared to 6 (95% CI 4 to 7) out of 100 for the active treatment group (given LRTA).
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Figure 5

In the control group (on ICS) 2 people out of 100 had withdrawal due to poor control over 4 to 52 weeks, compared to 6 (95% CI 4 to 7) out of 100 for the active treatment group (given LRTA).

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 1 Patients with at least one exacerbation requiring systemic steroids.
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Analysis 1.1

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 1 Patients with at least one exacerbation requiring systemic steroids.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 2 Patients with at least one exacerbation requiring hospital admission.
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Analysis 1.2

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 2 Patients with at least one exacerbation requiring hospital admission.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 3 Change from baseline FEV1 (L) at 4 ‐ 8 weeks.
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Analysis 1.3

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 3 Change from baseline FEV1 (L) at 4 ‐ 8 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 4 Change from baseline FEV1( L) 12 ‐ 16 weeks.
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Analysis 1.4

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 4 Change from baseline FEV1( L) 12 ‐ 16 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 5 Change from baseline FEV1 (L) at 24 ‐ 26 weeks.
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Analysis 1.5

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 5 Change from baseline FEV1 (L) at 24 ‐ 26 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 6 Change from baseline FEV1 (L) at 36 ‐ 52 weeks.
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Analysis 1.6

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 6 Change from baseline FEV1 (L) at 36 ‐ 52 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 7 FEV1 irrespective of time of treatment.
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Analysis 1.7

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 7 FEV1 irrespective of time of treatment.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 8 Responders (defined as change from baseline in FEV1 >= 7.5%.
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Analysis 1.8

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 8 Responders (defined as change from baseline in FEV1 >= 7.5%.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 9 Change from baseline FEV1 (%) at 4 ‐ 8 weeks.
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Analysis 1.9

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 9 Change from baseline FEV1 (%) at 4 ‐ 8 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 10 Change from baseline FEV1 (%) 12 ‐ 16 weeks.
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Analysis 1.10

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 10 Change from baseline FEV1 (%) 12 ‐ 16 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 11 Change from baseline FEV1 (%) at 24 ‐ 26 weeks.
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Analysis 1.11

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 11 Change from baseline FEV1 (%) at 24 ‐ 26 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 12 Change from baseline FEV1 % of predicted at 4 ‐ 8 weeks.
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Analysis 1.12

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 12 Change from baseline FEV1 % of predicted at 4 ‐ 8 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 13 Change from baseline FEV1 % of predicated at 12 ‐ 16 weeks.
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Analysis 1.13

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 13 Change from baseline FEV1 % of predicated at 12 ‐ 16 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 14 Change from baseline FEV1 % of predicated at 36 ‐ 52 weeks.
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Analysis 1.14

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 14 Change from baseline FEV1 % of predicated at 36 ‐ 52 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 15 Change from baseline AM PEFR (L/min) at 4 ‐ 8 weeks.
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Analysis 1.15

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 15 Change from baseline AM PEFR (L/min) at 4 ‐ 8 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 16 Change from baseline AM PEFR (L/min) at 12 ‐ 16 weeks.
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Analysis 1.16

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 16 Change from baseline AM PEFR (L/min) at 12 ‐ 16 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 17 Change from baseline AM PEFR (L/min) at 24 ‐ 26 weeks.
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Analysis 1.17

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 17 Change from baseline AM PEFR (L/min) at 24 ‐ 26 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 18 Change from baseline AM PEFR (L/min) at 36 ‐ 52 weeks.
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Analysis 1.18

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 18 Change from baseline AM PEFR (L/min) at 36 ‐ 52 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 19 Change from baseline daytime symptom scores at 4 ‐ 8 weeks.
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Analysis 1.19

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 19 Change from baseline daytime symptom scores at 4 ‐ 8 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 20 Change from baseline daytime symptom scores at 12 ‐ 16 weeks.
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Analysis 1.20

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 20 Change from baseline daytime symptom scores at 12 ‐ 16 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 21 Change from baseline daytime symptom scores at 24 ‐ 26 weeks.
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Analysis 1.21

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 21 Change from baseline daytime symptom scores at 24 ‐ 26 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 22 Change from baseline daytime symptom scores at 36 ‐ 52 weeks.
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Analysis 1.22

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 22 Change from baseline daytime symptom scores at 36 ‐ 52 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 23 Change from baseline night‐time awakenings at 4 ‐ 8 week.
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Analysis 1.23

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 23 Change from baseline night‐time awakenings at 4 ‐ 8 week.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 24 Change from baseline night‐time awakenings at 12 ‐ 16 weeks.
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Analysis 1.24

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 24 Change from baseline night‐time awakenings at 12 ‐ 16 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 25 Change from baseline night‐time awakenings at 24 ‐ 26 weeks.
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Analysis 1.25

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 25 Change from baseline night‐time awakenings at 24 ‐ 26 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 26 Change from baseline mean daily use of β2‐agonists at 4 ‐ 8 weeks.
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Analysis 1.26

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 26 Change from baseline mean daily use of β2‐agonists at 4 ‐ 8 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 27 Change from baseline mean daily use of β2‐agonists at 12 ‐ 16 weeks.
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Analysis 1.27

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 27 Change from baseline mean daily use of β2‐agonists at 12 ‐ 16 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 28 Change from baseline mean daily use of β2‐agonists at 24 ‐ 26 weeks.
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Analysis 1.28

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 28 Change from baseline mean daily use of β2‐agonists at 24 ‐ 26 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 29 Change from baseline mean daily use of β2‐agonists at 36 ‐ 52 weeks.
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Analysis 1.29

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 29 Change from baseline mean daily use of β2‐agonists at 36 ‐ 52 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 30 Change in rescue‐free days (%) at 4 ‐ 8 weeks.
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Analysis 1.30

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 30 Change in rescue‐free days (%) at 4 ‐ 8 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 31 Change in rescue‐free days (%) at 12 ‐ 16 weeks.
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Analysis 1.31

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 31 Change in rescue‐free days (%) at 12 ‐ 16 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 32 Change in rescue‐free days (%) at 24 ‐ 26 weeks.
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Analysis 1.32

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 32 Change in rescue‐free days (%) at 24 ‐ 26 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 33 Change in rescue‐free days (%) at 36 ‐ 52 weeks.
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Analysis 1.33

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 33 Change in rescue‐free days (%) at 36 ‐ 52 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 34 Change in proportion of symptom‐free days (%) at 4 ‐ 8 weeks.
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Analysis 1.34

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 34 Change in proportion of symptom‐free days (%) at 4 ‐ 8 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 35 Change in proportion of symptom‐free days (%) at 12 ‐ 16 weeks.
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Analysis 1.35

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 35 Change in proportion of symptom‐free days (%) at 12 ‐ 16 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 36 Change in proportion of symptom‐free days (%) at 24 ‐ 26 weeks.
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Analysis 1.36

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 36 Change in proportion of symptom‐free days (%) at 24 ‐ 26 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 37 Change in proportion of symptom‐free days (%) at 36 ‐ 52 weeks.
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Analysis 1.37

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 37 Change in proportion of symptom‐free days (%) at 36 ‐ 52 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 38 Change from baseline quality of life (QOL) at 4 ‐ 8 weeks.
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Analysis 1.38

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 38 Change from baseline quality of life (QOL) at 4 ‐ 8 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 39 Change from baseline quality of life (QOL) at 12 ‐ 16 weeks.
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Analysis 1.39

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 39 Change from baseline quality of life (QOL) at 12 ‐ 16 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 40 Change from baseline quality of life (QOL) at 24 ‐ 26 weeks.
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Analysis 1.40

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 40 Change from baseline quality of life (QOL) at 24 ‐ 26 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 41 Change from baseline quality of life (QOL) at 36 ‐ 52 weeks.
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Analysis 1.41

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 41 Change from baseline quality of life (QOL) at 36 ‐ 52 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 42 Days with use of β2‐agonists at 36 ‐ 52 weeks.
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Analysis 1.42

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 42 Days with use of β2‐agonists at 36 ‐ 52 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 43 Change from baseline blood eosinophils at 4 ‐ 8 weeks.
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Analysis 1.43

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 43 Change from baseline blood eosinophils at 4 ‐ 8 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 44 Change from baseline blood eosinophils at 12 ‐ 16 weeks.
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Analysis 1.44

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 44 Change from baseline blood eosinophils at 12 ‐ 16 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 45 % Change in sputum eosinophils at 4 ‐ 8 weeks.
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Analysis 1.45

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 45 % Change in sputum eosinophils at 4 ‐ 8 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 46 % Change in sputum eosinophils at 36 ‐ 52 weeks.
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Analysis 1.46

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 46 % Change in sputum eosinophils at 36 ‐ 52 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 47 LTC4 concentration (ng/mL) in nasal wash at 24 ‐ 26 weeks.
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Analysis 1.47

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 47 LTC4 concentration (ng/mL) in nasal wash at 24 ‐ 26 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 48 % Asthma control days during intervention period at 4 ‐ 8 weeks.
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Analysis 1.48

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 48 % Asthma control days during intervention period at 4 ‐ 8 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 49 % Asthma control days during intervention period at 24 ‐ 26 weeks.
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Analysis 1.49

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 49 % Asthma control days during intervention period at 24 ‐ 26 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 50 Change in PC20 at 4 ‐ 8 weeks.
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Analysis 1.50

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 50 Change in PC20 at 4 ‐ 8 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 51 % rescue ‐ free days at 24 ‐ 26 weeks.
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Analysis 1.51

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 51 % rescue ‐ free days at 24 ‐ 26 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 52 Days off work or school at 24 ‐ 26 weeks.
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Analysis 1.52

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 52 Days off work or school at 24 ‐ 26 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 53 Change in height (cm).
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Analysis 1.53

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 53 Change in height (cm).

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 54 Patient's satisfaction at 4 ‐ 8 weeks.
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Analysis 1.54

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 54 Patient's satisfaction at 4 ‐ 8 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 55 Physician's satisfaction at 4 ‐ 8 weeks.
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Analysis 1.55

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 55 Physician's satisfaction at 4 ‐ 8 weeks.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 56 Overall Withdrawals.
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Analysis 1.56

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 56 Overall Withdrawals.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 57 Withdrawal due to poor asthma control/exacerbations.
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Analysis 1.57

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 57 Withdrawal due to poor asthma control/exacerbations.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 58 Withdrawals due to adverse effects.
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Analysis 1.58

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 58 Withdrawals due to adverse effects.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 59 Overall Adverse effects.
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Analysis 1.59

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 59 Overall Adverse effects.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 60 Elevated liver enzymes.
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Analysis 1.60

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 60 Elevated liver enzymes.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 61 Upper respiratory tract infections.
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Analysis 1.61

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 61 Upper respiratory tract infections.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 62 Headache.
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Analysis 1.62

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 62 Headache.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 63 Nausea.
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Analysis 1.63

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 63 Nausea.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 64 Oral candidiasis.
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Analysis 1.64

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 64 Oral candidiasis.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 65 Hoarseness.
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Analysis 1.65

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 65 Hoarseness.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 66 Death.
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Analysis 1.66

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 66 Death.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 67 Primary outcome ‐ stratified by anti‐leukotrienes.
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Analysis 1.67

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 67 Primary outcome ‐ stratified by anti‐leukotrienes.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 68 Primary outcome ‐ stratified by duration of intervention.
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Analysis 1.68

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 68 Primary outcome ‐ stratified by duration of intervention.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 69 Main outcome ‐stratified by severity of airway obstruction.
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Analysis 1.69

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 69 Main outcome ‐stratified by severity of airway obstruction.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 70 Primary outcome ‐ stratified by methodological quality.
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Analysis 1.70

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 70 Primary outcome ‐ stratified by methodological quality.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 71 Primary outcome‐ stratified by funding source.
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Analysis 1.71

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 71 Primary outcome‐ stratified by funding source.

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 72 Primary outcome ‐ stratified by HFC‐BDP equivalent.
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Analysis 1.72

Comparison 1 Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent), Outcome 72 Primary outcome ‐ stratified by HFC‐BDP equivalent.

Comparison 1. Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Patients with at least one exacerbation requiring systemic steroids Show forest plot

21

6077

Risk Ratio (M‐H, Random, 95% CI)

1.51 [1.17, 1.96]

1.1 Paediatrics

6

1662

Risk Ratio (M‐H, Random, 95% CI)

1.35 [0.99, 1.86]

1.2 Adults

15

4415

Risk Ratio (M‐H, Random, 95% CI)

1.61 [1.12, 2.31]

2 Patients with at least one exacerbation requiring hospital admission Show forest plot

12

2715

Risk Ratio (M‐H, Fixed, 95% CI)

3.33 [1.02, 10.94]

2.1 Paediatrics

4

558

Risk Ratio (M‐H, Fixed, 95% CI)

3.04 [0.12, 73.98]

2.2 Adults

8

2157

Risk Ratio (M‐H, Fixed, 95% CI)

3.38 [0.94, 12.17]

3 Change from baseline FEV1 (L) at 4 ‐ 8 weeks Show forest plot

12

3020

Mean Difference (IV, Random, 95% CI)

‐0.12 [‐0.15, ‐0.08]

3.1 Paediatrics

1

56

Mean Difference (IV, Random, 95% CI)

‐0.28 [‐0.69, 0.13]

3.2 Adults

11

2964

Mean Difference (IV, Random, 95% CI)

‐0.12 [‐0.15, ‐0.08]

4 Change from baseline FEV1( L) 12 ‐ 16 weeks Show forest plot

8

1778

Mean Difference (IV, Random, 95% CI)

‐0.12 [‐0.20, ‐0.04]

4.1 Paediatrics

2

179

Mean Difference (IV, Random, 95% CI)

‐0.02 [‐0.13, 0.09]

4.2 Adults

6

1599

Mean Difference (IV, Random, 95% CI)

‐0.14 [‐0.24, ‐0.05]

5 Change from baseline FEV1 (L) at 24 ‐ 26 weeks Show forest plot

3

1178

Mean Difference (IV, Random, 95% CI)

‐0.13 [‐0.22, ‐0.04]

5.1 Paediatrics

1

123

Mean Difference (IV, Random, 95% CI)

‐0.01 [‐0.14, 0.12]

5.2 Adults

2

1055

Mean Difference (IV, Random, 95% CI)

‐0.17 [‐0.23, ‐0.11]

6 Change from baseline FEV1 (L) at 36 ‐ 52 weeks Show forest plot

2

1040

Mean Difference (IV, Fixed, 95% CI)

‐0.03 [‐0.07, 0.00]

6.1 Paediatrics

2

1040

Mean Difference (IV, Fixed, 95% CI)

‐0.03 [‐0.07, 0.00]

7 FEV1 irrespective of time of treatment Show forest plot

23

7016

Mean Difference (IV, Random, 95% CI)

‐0.11 [‐0.14, ‐0.08]

7.1 Paediatrics

4

1398

Mean Difference (IV, Random, 95% CI)

‐0.03 [‐0.07, 0.00]

7.2 Adults

19

5618

Mean Difference (IV, Random, 95% CI)

‐0.13 [‐0.16, ‐0.09]

8 Responders (defined as change from baseline in FEV1 >= 7.5% Show forest plot

1

Odds Ratio (Fixed, 95% CI)

Totals not selected

9 Change from baseline FEV1 (%) at 4 ‐ 8 weeks Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

9.1 Adults

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

10 Change from baseline FEV1 (%) 12 ‐ 16 weeks Show forest plot

2

603

Mean Difference (IV, Fixed, 95% CI)

‐5.70 [‐9.81, ‐1.59]

10.1 Adults

2

603

Mean Difference (IV, Fixed, 95% CI)

‐5.70 [‐9.81, ‐1.59]

11 Change from baseline FEV1 (%) at 24 ‐ 26 weeks Show forest plot

2

838

Mean Difference (IV, Fixed, 95% CI)

‐8.20 [‐10.85, ‐5.55]

11.1 Adults

2

838

Mean Difference (IV, Fixed, 95% CI)

‐8.20 [‐10.85, ‐5.55]

12 Change from baseline FEV1 % of predicted at 4 ‐ 8 weeks Show forest plot

2

219

Mean Difference (IV, Random, 95% CI)

‐2.58 [‐6.56, 1.40]

12.1 Paediatrics

1

183

Mean Difference (IV, Random, 95% CI)

‐0.54 [‐4.82, 3.74]

12.2 Adults

1

36

Mean Difference (IV, Random, 95% CI)

‐4.6 [‐8.86, ‐0.34]

13 Change from baseline FEV1 % of predicated at 12 ‐ 16 weeks Show forest plot

3

948

Mean Difference (IV, Fixed, 95% CI)

‐3.76 [‐5.01, ‐2.50]

13.1 Paediatrics

1

335

Mean Difference (IV, Fixed, 95% CI)

‐6.02 [‐9.45, ‐2.59]

13.2 Adults

2

613

Mean Difference (IV, Fixed, 95% CI)

‐3.41 [‐4.76, ‐2.06]

14 Change from baseline FEV1 % of predicated at 36 ‐ 52 weeks Show forest plot

3

1229

Mean Difference (IV, Random, 95% CI)

‐3.51 [‐7.14, 0.12]

14.1 Paediatrics

3

1229

Mean Difference (IV, Random, 95% CI)

‐3.51 [‐7.14, 0.12]

15 Change from baseline AM PEFR (L/min) at 4 ‐ 8 weeks Show forest plot

8

1926

Mean Difference (IV, Random, 95% CI)

‐15.12 [‐20.80, ‐9.44]

15.1 Paediatrics

1

332

Mean Difference (IV, Random, 95% CI)

‐7.76 [‐13.43, ‐2.09]

15.2 Adults

7

1594

Mean Difference (IV, Random, 95% CI)

‐17.63 [‐22.56, ‐12.69]

16 Change from baseline AM PEFR (L/min) at 12 ‐ 16 weeks Show forest plot

9

2601

Mean Difference (IV, Random, 95% CI)

‐19.07 [‐25.86, ‐12.27]

16.1 Paediatrics

1

335

Mean Difference (IV, Random, 95% CI)

‐16.9 [‐28.54, ‐5.26]

16.2 Adults

8

2266

Mean Difference (IV, Random, 95% CI)

‐19.57 [‐27.27, ‐11.87]

17 Change from baseline AM PEFR (L/min) at 24 ‐ 26 weeks Show forest plot

3

1718

Mean Difference (IV, Random, 95% CI)

‐21.62 [‐40.19, ‐3.05]

17.1 Adults

3

1718

Mean Difference (IV, Random, 95% CI)

‐21.62 [‐40.19, ‐3.05]

18 Change from baseline AM PEFR (L/min) at 36 ‐ 52 weeks Show forest plot

3

1028

Mean Difference (IV, Random, 95% CI)

‐5.06 [‐10.58, 0.45]

18.1 Adults

3

1028

Mean Difference (IV, Random, 95% CI)

‐5.06 [‐10.58, 0.45]

19 Change from baseline daytime symptom scores at 4 ‐ 8 weeks Show forest plot

6

1925

Std. Mean Difference (IV, Random, 95% CI)

0.20 [0.08, 0.32]

19.1 Paediatrics

1

393

Std. Mean Difference (IV, Random, 95% CI)

0.06 [‐0.14, 0.26]

19.2 Adults

5

1532

Std. Mean Difference (IV, Random, 95% CI)

0.23 [0.11, 0.36]

20 Change from baseline daytime symptom scores at 12 ‐ 16 weeks Show forest plot

9

2650

Std. Mean Difference (IV, Fixed, 95% CI)

0.25 [0.18, 0.33]

20.1 Paediatrics

2

388

Std. Mean Difference (IV, Fixed, 95% CI)

0.28 [0.08, 0.48]

20.2 Adults

7

2262

Std. Mean Difference (IV, Fixed, 95% CI)

0.25 [0.16, 0.33]

21 Change from baseline daytime symptom scores at 24 ‐ 26 weeks Show forest plot

3

1719

Std. Mean Difference (IV, Random, 95% CI)

0.22 [0.02, 0.42]

21.1 Adults

3

1719

Std. Mean Difference (IV, Random, 95% CI)

0.22 [0.02, 0.42]

22 Change from baseline daytime symptom scores at 36 ‐ 52 weeks Show forest plot

2

582

Std. Mean Difference (IV, Random, 95% CI)

0.16 [‐0.02, 0.34]

22.1 Paediatrics

2

582

Std. Mean Difference (IV, Random, 95% CI)

0.16 [‐0.02, 0.34]

23 Change from baseline night‐time awakenings at 4 ‐ 8 week Show forest plot

3

798

Std. Mean Difference (IV, Random, 95% CI)

0.22 [‐0.02, 0.46]

23.1 Adults

3

798

Std. Mean Difference (IV, Random, 95% CI)

0.22 [‐0.02, 0.46]

24 Change from baseline night‐time awakenings at 12 ‐ 16 weeks Show forest plot

9

2916

Std. Mean Difference (IV, Fixed, 95% CI)

0.18 [0.11, 0.26]

24.1 Adults

9

2916

Std. Mean Difference (IV, Fixed, 95% CI)

0.18 [0.11, 0.26]

25 Change from baseline night‐time awakenings at 24 ‐ 26 weeks Show forest plot

2

1055

Std. Mean Difference (IV, Fixed, 95% CI)

0.23 [0.11, 0.35]

25.1 Adults

2

1055

Std. Mean Difference (IV, Fixed, 95% CI)

0.23 [0.11, 0.35]

26 Change from baseline mean daily use of β2‐agonists at 4 ‐ 8 weeks Show forest plot

10

3264

Std. Mean Difference (IV, Random, 95% CI)

0.20 [0.07, 0.34]

26.1 Paediatrics

1

393

Std. Mean Difference (IV, Random, 95% CI)

‐0.02 [‐0.22, 0.17]

26.2 Adults

9

2871

Std. Mean Difference (IV, Random, 95% CI)

0.24 [0.10, 0.38]

27 Change from baseline mean daily use of β2‐agonists at 12 ‐ 16 weeks Show forest plot

11

3367

Std. Mean Difference (IV, Fixed, 95% CI)

0.23 [0.17, 0.30]

27.1 Paediatrics

1

335

Std. Mean Difference (IV, Fixed, 95% CI)

0.02 [‐0.20, 0.23]

27.2 Adults

10

3032

Std. Mean Difference (IV, Fixed, 95% CI)

0.26 [0.19, 0.33]

28 Change from baseline mean daily use of β2‐agonists at 24 ‐ 26 weeks Show forest plot

2

1055

Std. Mean Difference (IV, Fixed, 95% CI)

0.31 [0.19, 0.43]

28.1 Adults

2

1055

Std. Mean Difference (IV, Fixed, 95% CI)

0.31 [0.19, 0.43]

29 Change from baseline mean daily use of β2‐agonists at 36 ‐ 52 weeks Show forest plot

1

Std. Mean Difference (IV, Fixed, 95% CI)

Totals not selected

29.1 Paediatrics

1

Std. Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

30 Change in rescue‐free days (%) at 4 ‐ 8 weeks Show forest plot

5

1315

Mean Difference (IV, Random, 95% CI)

‐6.83 [‐17.73, 4.07]

30.1 Paediatrics

1

393

Mean Difference (IV, Random, 95% CI)

2.72 [‐3.11, 8.55]

30.2 Adults

4

922

Mean Difference (IV, Random, 95% CI)

‐13.25 [‐18.11, ‐8.39]

31 Change in rescue‐free days (%) at 12 ‐ 16 weeks Show forest plot

7

2304

Mean Difference (IV, Random, 95% CI)

‐9.64 [‐13.71, ‐5.56]

31.1 Paediatrics

1

335

Mean Difference (IV, Random, 95% CI)

‐10.10 [‐18.97, ‐1.23]

31.2 Adults

6

1969

Mean Difference (IV, Random, 95% CI)

‐9.64 [‐14.39, ‐4.89]

32 Change in rescue‐free days (%) at 24 ‐ 26 weeks Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

32.1 Adults

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

33 Change in rescue‐free days (%) at 36 ‐ 52 weeks Show forest plot

2

1350

Mean Difference (IV, Fixed, 95% CI)

‐2.59 [‐4.97, ‐0.21]

33.1 Paediatrics

2

1350

Mean Difference (IV, Fixed, 95% CI)

‐2.59 [‐4.97, ‐0.21]

33.2 Adults

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

34 Change in proportion of symptom‐free days (%) at 4 ‐ 8 weeks Show forest plot

3

1154

Mean Difference (IV, Fixed, 95% CI)

‐10.46 [‐14.56, ‐6.36]

34.1 Adults

3

1154

Mean Difference (IV, Fixed, 95% CI)

‐10.46 [‐14.56, ‐6.36]

35 Change in proportion of symptom‐free days (%) at 12 ‐ 16 weeks Show forest plot

8

2423

Mean Difference (IV, Fixed, 95% CI)

‐8.89 [‐11.92, ‐5.87]

35.1 Paediatrics

1

335

Mean Difference (IV, Fixed, 95% CI)

‐6.40 [‐15.82, 3.02]

35.2 Adults

7

2088

Mean Difference (IV, Fixed, 95% CI)

‐9.18 [‐12.38, ‐5.98]

36 Change in proportion of symptom‐free days (%) at 24 ‐ 26 weeks Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

36.1 Adults

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

37 Change in proportion of symptom‐free days (%) at 36 ‐ 52 weeks Show forest plot

3

1190

Mean Difference (IV, Fixed, 95% CI)

‐5.49 [‐9.06, ‐1.91]

37.1 Paediatrics

2

575

Mean Difference (IV, Fixed, 95% CI)

‐4.90 [‐9.73, ‐0.08]

37.2 Adults

1

615

Mean Difference (IV, Fixed, 95% CI)

‐6.20 [‐11.53, ‐0.87]

38 Change from baseline quality of life (QOL) at 4 ‐ 8 weeks Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

38.1 Adults

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

39 Change from baseline quality of life (QOL) at 12 ‐ 16 weeks Show forest plot

2

1065

Mean Difference (IV, Fixed, 95% CI)

‐0.21 [‐0.34, ‐0.09]

39.1 Adults

2

1065

Mean Difference (IV, Fixed, 95% CI)

‐0.21 [‐0.34, ‐0.09]

40 Change from baseline quality of life (QOL) at 24 ‐ 26 weeks Show forest plot

2

1028

Mean Difference (IV, Fixed, 95% CI)

‐0.38 [‐0.54, ‐0.21]

40.1 Adults

2

1028

Mean Difference (IV, Fixed, 95% CI)

‐0.38 [‐0.54, ‐0.21]

41 Change from baseline quality of life (QOL) at 36 ‐ 52 weeks Show forest plot

1

541

Mean Difference (IV, Fixed, 95% CI)

‐0.13 [‐0.33, 0.07]

41.1 Paediatrics

1

541

Mean Difference (IV, Fixed, 95% CI)

‐0.13 [‐0.33, 0.07]

41.2 Adults

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

42 Days with use of β2‐agonists at 36 ‐ 52 weeks Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

42.1 Paediatrics

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

43 Change from baseline blood eosinophils at 4 ‐ 8 weeks Show forest plot

4

1294

Mean Difference (IV, Random, 95% CI)

0.06 [0.02, 0.10]

43.1 Adults

4

1294

Mean Difference (IV, Random, 95% CI)

0.06 [0.02, 0.10]

44 Change from baseline blood eosinophils at 12 ‐ 16 weeks Show forest plot

2

1013

Mean Difference (IV, Fixed, 95% CI)

‐0.00 [‐0.03, 0.02]

44.1 Adults

2

1013

Mean Difference (IV, Fixed, 95% CI)

‐0.00 [‐0.03, 0.02]

45 % Change in sputum eosinophils at 4 ‐ 8 weeks Show forest plot

2

117

Mean Difference (IV, Random, 95% CI)

0.71 [‐2.06, 3.47]

45.1 Adults

2

117

Mean Difference (IV, Random, 95% CI)

0.71 [‐2.06, 3.47]

46 % Change in sputum eosinophils at 36 ‐ 52 weeks Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

46.1 Paediatrics

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

47 LTC4 concentration (ng/mL) in nasal wash at 24 ‐ 26 weeks Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

47.1 Paediatrics

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

48 % Asthma control days during intervention period at 4 ‐ 8 weeks Show forest plot

2

1293

Mean Difference (IV, Fixed, 95% CI)

‐5.72 [‐10.86, ‐0.59]

48.1 Adults

2

1293

Mean Difference (IV, Fixed, 95% CI)

‐5.72 [‐10.86, ‐0.59]

49 % Asthma control days during intervention period at 24 ‐ 26 weeks Show forest plot

2

1185

Mean Difference (IV, Random, 95% CI)

‐8.19 [‐19.46, 3.07]

49.1 Adults

2

1185

Mean Difference (IV, Random, 95% CI)

‐8.19 [‐19.46, 3.07]

50 Change in PC20 at 4 ‐ 8 weeks Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

50.1 Adults

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

51 % rescue ‐ free days at 24 ‐ 26 weeks Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

51.1 Adults

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

52 Days off work or school at 24 ‐ 26 weeks Show forest plot

2

606

Mean Difference (IV, Fixed, 95% CI)

0.12 [‐0.01, 0.26]

52.1 Paediatrics

1

124

Mean Difference (IV, Fixed, 95% CI)

‐0.24 [‐1.31, 0.83]

52.2 Adults

1

482

Mean Difference (IV, Fixed, 95% CI)

0.13 [‐0.00, 0.26]

53 Change in height (cm) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

53.1 Paediatrics

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

54 Patient's satisfaction at 4 ‐ 8 weeks Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

54.1 Adults

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

55 Physician's satisfaction at 4 ‐ 8 weeks Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

55.1 Adults

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

56 Overall Withdrawals Show forest plot

42

10939

Risk Ratio (M‐H, Random, 95% CI)

1.22 [1.08, 1.38]

56.1 Paediatrics

18

3397

Risk Ratio (M‐H, Random, 95% CI)

1.03 [0.88, 1.21]

56.2 Adults

24

7542

Risk Ratio (M‐H, Random, 95% CI)

1.31 [1.11, 1.54]

57 Withdrawal due to poor asthma control/exacerbations Show forest plot

26

7669

Risk Ratio (M‐H, Fixed, 95% CI)

2.56 [2.01, 3.27]

57.1 Paediatrics

7

1219

Risk Ratio (M‐H, Fixed, 95% CI)

2.17 [1.20, 3.94]

57.2 Adults

19

6450

Risk Ratio (M‐H, Fixed, 95% CI)

2.64 [2.02, 3.45]

58 Withdrawals due to adverse effects Show forest plot

25

8518

Risk Ratio (M‐H, Fixed, 95% CI)

1.24 [0.95, 1.63]

58.1 Paediatrics

8

2330

Risk Ratio (M‐H, Fixed, 95% CI)

1.27 [0.70, 2.33]

58.2 Adults

17

6188

Risk Ratio (M‐H, Fixed, 95% CI)

1.23 [0.91, 1.67]

59 Overall Adverse effects Show forest plot

22

7818

Risk Ratio (M‐H, Fixed, 95% CI)

1.00 [0.95, 1.05]

59.1 Paediatrics

3

1460

Risk Ratio (M‐H, Fixed, 95% CI)

1.02 [0.90, 1.15]

59.2 Adults

19

6358

Risk Ratio (M‐H, Fixed, 95% CI)

0.99 [0.94, 1.05]

60 Elevated liver enzymes Show forest plot

7

1761

Risk Ratio (M‐H, Fixed, 95% CI)

1.13 [0.58, 2.19]

60.1 Paediatrics

1

118

Risk Ratio (M‐H, Fixed, 95% CI)

0.49 [0.03, 7.68]

60.2 Adults

6

1643

Risk Ratio (M‐H, Fixed, 95% CI)

1.19 [0.60, 2.36]

61 Upper respiratory tract infections Show forest plot

8

2729

Odds Ratio (M‐H, Fixed, 95% CI)

1.04 [0.84, 1.29]

61.1 Paediatrics

5

1514

Odds Ratio (M‐H, Fixed, 95% CI)

1.05 [0.81, 1.36]

61.2 Adults

3

1215

Odds Ratio (M‐H, Fixed, 95% CI)

1.01 [0.69, 1.50]

62 Headache Show forest plot

24

8872

Risk Ratio (M‐H, Fixed, 95% CI)

0.99 [0.89, 1.11]

62.1 Paediatrics

6

2589

Risk Ratio (M‐H, Fixed, 95% CI)

1.05 [0.81, 1.37]

62.2 Adults

18

6283

Risk Ratio (M‐H, Fixed, 95% CI)

0.98 [0.86, 1.10]

63 Nausea Show forest plot

17

5563

Risk Ratio (M‐H, Fixed, 95% CI)

0.83 [0.64, 1.08]

63.1 Paediatrics

2

465

Risk Ratio (M‐H, Fixed, 95% CI)

0.80 [0.28, 2.31]

63.2 Adults

15

5098

Risk Ratio (M‐H, Fixed, 95% CI)

0.83 [0.64, 1.09]

64 Oral candidiasis Show forest plot

3

865

Risk Ratio (M‐H, Fixed, 95% CI)

0.25 [0.05, 1.19]

64.1 Adults

3

865

Risk Ratio (M‐H, Fixed, 95% CI)

0.25 [0.05, 1.19]

65 Hoarseness Show forest plot

2

734

Risk Ratio (M‐H, Fixed, 95% CI)

0.25 [0.03, 2.24]

65.1 Adults

2

734

Risk Ratio (M‐H, Fixed, 95% CI)

0.25 [0.03, 2.24]

66 Death Show forest plot

13

5489

Risk Ratio (M‐H, Fixed, 95% CI)

3.05 [0.32, 29.26]

66.1 Paediatrics

2

1114

Risk Ratio (M‐H, Fixed, 95% CI)

3.0 [0.12, 73.46]

66.2 Adults

11

4375

Risk Ratio (M‐H, Fixed, 95% CI)

3.10 [0.13, 75.82]

67 Primary outcome ‐ stratified by anti‐leukotrienes Show forest plot

21

6077

Odds Ratio (M‐H, Random, 95% CI)

1.61 [1.20, 2.16]

67.1 Monelukast

15

4352

Odds Ratio (M‐H, Random, 95% CI)

1.55 [1.14, 2.12]

67.2 Zafirlukast

6

1725

Odds Ratio (M‐H, Random, 95% CI)

1.92 [0.88, 4.20]

68 Primary outcome ‐ stratified by duration of intervention Show forest plot

21

6077

Risk Ratio (M‐H, Random, 95% CI)

1.51 [1.17, 1.96]

68.1 4‐8 weeks

9

2346

Risk Ratio (M‐H, Random, 95% CI)

1.74 [0.78, 3.87]

68.2 12‐16 weeks

7

1541

Risk Ratio (M‐H, Random, 95% CI)

2.06 [1.43, 2.96]

68.3 24‐26 weeks

2

657

Risk Ratio (M‐H, Random, 95% CI)

1.17 [0.55, 2.45]

68.4 36‐52 weeks

3

1533

Risk Ratio (M‐H, Random, 95% CI)

1.29 [0.87, 1.91]

69 Main outcome ‐stratified by severity of airway obstruction Show forest plot

21

6077

Risk Ratio (M‐H, Random, 95% CI)

1.51 [1.17, 1.96]

69.1 Mean FEV1 60‐80% of predicted

11

3922

Risk Ratio (M‐H, Random, 95% CI)

2.03 [1.41, 2.91]

69.2 Mean FEV1 ≥80% of predicted

10

2155

Risk Ratio (M‐H, Random, 95% CI)

1.25 [0.97, 1.61]

70 Primary outcome ‐ stratified by methodological quality Show forest plot

21

6061

Risk Ratio (M‐H, Random, 95% CI)

1.51 [1.17, 1.96]

70.1 High quality

11

4366

Risk Ratio (M‐H, Random, 95% CI)

1.62 [1.29, 2.03]

70.2 Poor quality

10

1695

Risk Ratio (M‐H, Random, 95% CI)

1.34 [0.74, 2.43]

71 Primary outcome‐ stratified by funding source Show forest plot

21

6077

Risk Ratio (M‐H, Random, 95% CI)

1.51 [1.17, 1.96]

71.1 Funded by producers of ICS

9

2638

Risk Ratio (M‐H, Random, 95% CI)

1.71 [1.05, 2.80]

71.2 Funded by producers of AL

5

2797

Risk Ratio (M‐H, Random, 95% CI)

1.52 [0.99, 2.35]

71.3 No industry funding or not reported

7

642

Risk Ratio (M‐H, Random, 95% CI)

1.22 [0.90, 1.66]

72 Primary outcome ‐ stratified by HFC‐BDP equivalent Show forest plot

21

6077

Odds Ratio (M‐H, Random, 95% CI)

1.61 [1.20, 2.16]

72.1 100‐150 μg HFA‐BDP equivalent

3

216

Odds Ratio (M‐H, Random, 95% CI)

0.74 [0.26, 2.08]

72.2 200‐250 μg HFA‐BDP equivalent

15

5767

Odds Ratio (M‐H, Random, 95% CI)

1.75 [1.29, 2.38]

72.3 400‐500 μg HFA‐BDP equivalent

3

94

Odds Ratio (M‐H, Random, 95% CI)

0.54 [0.11, 2.78]

Figures and Tables -
Comparison 1. Anti‐leukotriene (AL) vs. Inhaled glucocorticoids (in HFC‐BDP equivalent)