Fluticasone versus 'extrafine' HFA‐beclomethasone dipropionate for chronic asthma in adults and children

Toby J Lasserson; Christopher J Cates; Emma H Lasserson; John White

doi:10.1002/14651858.CD005309.pub3

Scolaris Content Display Scolaris Content Display

Contenido relacionado

Ir a:

Revisiones y protocolos relacionados
Guías
Temas

Revisiones y protocolos relacionados

Topics

Temas

Figure 1

Methodological quality summary: review authors' judgements about each methodological quality item for each included study.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.1

Comparison 1 FP versus HFA‐BDP (dose ratio 1:1; parallel group trials), Outcome 1 Change in FEV1 (Litres).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.2

Comparison 1 FP versus HFA‐BDP (dose ratio 1:1; parallel group trials), Outcome 2 Change in FEV1 % predicted.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.3

Comparison 1 FP versus HFA‐BDP (dose ratio 1:1; parallel group trials), Outcome 3 Change in morning PEFR compared to baseline (L/min).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.4

Comparison 1 FP versus HFA‐BDP (dose ratio 1:1; parallel group trials), Outcome 4 Change in PEFR predicted (%).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.5

Comparison 1 FP versus HFA‐BDP (dose ratio 1:1; parallel group trials), Outcome 5 Beta‐agonist use (puffs/day).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.6

Comparison 1 FP versus HFA‐BDP (dose ratio 1:1; parallel group trials), Outcome 6 Beta‐agonist use (% reduction in days using beta‐agonist).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.7

Comparison 1 FP versus HFA‐BDP (dose ratio 1:1; parallel group trials), Outcome 7 Change in rescue medication usage (Juniper questionnaire item 6).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.8

Comparison 1 FP versus HFA‐BDP (dose ratio 1:1; parallel group trials), Outcome 8 Change in asthma‐free days per week.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.9

Comparison 1 FP versus HFA‐BDP (dose ratio 1:1; parallel group trials), Outcome 9 Change in % days without asthma symptoms.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.10

Comparison 1 FP versus HFA‐BDP (dose ratio 1:1; parallel group trials), Outcome 10 Change in heath‐related quality of life (AQLQ).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.11

Comparison 1 FP versus HFA‐BDP (dose ratio 1:1; parallel group trials), Outcome 11 Change in health‐related quality of life (ACQ).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.12

Comparison 1 FP versus HFA‐BDP (dose ratio 1:1; parallel group trials), Outcome 12 Withdrawals (any reason).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.13

Comparison 1 FP versus HFA‐BDP (dose ratio 1:1; parallel group trials), Outcome 13 Dysphonia.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.14

Comparison 1 FP versus HFA‐BDP (dose ratio 1:1; parallel group trials), Outcome 14 Headache.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.15

Comparison 1 FP versus HFA‐BDP (dose ratio 1:1; parallel group trials), Outcome 15 Increased asthma symptoms.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.16

Comparison 1 FP versus HFA‐BDP (dose ratio 1:1; parallel group trials), Outcome 16 Oral candidiasis.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.17

Comparison 1 FP versus HFA‐BDP (dose ratio 1:1; parallel group trials), Outcome 17 Any adverse event.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.18

Comparison 1 FP versus HFA‐BDP (dose ratio 1:1; parallel group trials), Outcome 18 Admission to hospital for asthma.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.1

Comparison 2 FP versus HFA‐BDP (dose ratio 1:1; crossover trials), Outcome 1 FEV1 (predicted).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.2

Comparison 2 FP versus HFA‐BDP (dose ratio 1:1; crossover trials), Outcome 2 Morning PEFR.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.3

Comparison 2 FP versus HFA‐BDP (dose ratio 1:1; crossover trials), Outcome 3 Asthma Control Questionnaire.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.4

Comparison 2 FP versus HFA‐BDP (dose ratio 1:1; crossover trials), Outcome 4 Growth (cm).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Table 1. Search history

Date	Search detail
All years: <March 2005	Total number of references: 158 Excluded at abstract stage: 126 References identified for additional scrutiny: 34 Unique studies identified: 21 Awaiting assessment: 1 Excluded: 13 Included: 7
March 2005 to January 2006	Total number of references: 22 Excluded at abstract stage: 15 References to studies already included: 1 References retrieved for further scrutiny: 6 Unique studies identified: 5 Awating assessment: 0 Excluded: 4 Included: 1
January 2006 to January 2007	Total number of references: 20 Excluded at abstract stage: 17 References to studies already included: 0 References retrieved for further scrutiny: 3 Unique studies identified: 3 Awating assessment: 0 Excluded: 3 Included: 0
January 2009 to January 2010	Total number of references: 21 Excluded at abstract stage: 21

Table 1. Search history

Ir a la tabla de la revisión

Table 2. Approximation of asthma severity

Study ID	IC FEV1 (% predicted)	BL FEV1	BL symptoms	Oral steroids at BL	ICS at BL	Author opinion	Approx severity
Ahrens 2003	Not stated (described as 'abnormal')	Not stated	Not stated	Not stated	Yes ‐ CFC‐BDP 200mcg/d	Not stated	Unclear
Aubier 2001	Not stated	71.7‐8%	Asthma symptoms had to clinically indicate an increase in steroid treatment on previous treatment by 500‐1000mcg/day, with 'as required' ß‐agonist	No	Yes: requiring BDP equivalent 500‐1000 mcg/d	Moderate to severe	Moderate to severe
Currie 2002	>70% predicted	87.9‐89%	Not stated. Treatment with SABA only for previous 3 months	No	Yes	Mild to moderate	Mild to moderate
Fairfax 2001	Not stated	75.7‐78.2%	At least one of: sleep disturbance; daily use of at least 2 puffs SABA; daily score of at least 2 on three days for wheeze, cough, shortness of breath, chest tightness	No	Yes ‐ Equivalent to FP100‐250mcg/d	Moderate	Moderate
Huchon 2003	Not stated	Not stated	Not stated	Not stated	Not stated	Mild to moderate	Unclear
Molimard 2005	No details	76‐9% predicted	Requirement for 2 puffs SABA/day	No	Yes: inadequate control of symptoms at </=500mcg/d FP	Moderate‐severe	Moderate
van Aalderan 2007	Not stated	87% predicted	'...sub‐optimal asthma control requiring the initiation of, or an increase in current ICS therapy.'	Not stated	Yes (BDP 200mcg day or equivalent)	Mild to moderate	Mild to moderate
Robroeks 2008	Not stated	107%	Not stated	No	Yes ‐ equivalent to 500mcg or less of FP equivalent	Moderate	Mild to Moderate
Thongngam 2005	<80% predicted	57% predicted	Symptomatic despite requirement for medium‐high dose ICS	Yes ‐ course of OCS within three months	Yes ‐ moderate‐high doses of ICS required	Moderate to severe	Moderate to severe
Tunon‐de‐Lara 2007	>60% predicted	88% predicted	>/=7 puffs of SABA or 2 nocturnal symptoms, or mild limitation of activity linked to asthma symptoms in last 15 days	No	Yes ‐ up to 1000mcg/d	Mild to moderate	Mild to moderate
BL= baseline IC= inclusion criterion OCS= oral corticosteroid ICS= inhaled corticosteroid

Table 2. Approximation of asthma severity

Ir a la tabla de la revisión

Comparison 1. FP versus HFA‐BDP (dose ratio 1:1; parallel group trials)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Change in FEV1 (Litres) Show forest plot	3	659	Mean Difference (IV, Fixed, 95% CI)	0.04 [‐0.03, 0.11]

2 Change in FEV1 % predicted Show forest plot	3	334	Mean Difference (IV, Fixed, 95% CI)	‐2.18 [‐4.62, 0.26]

3 Change in morning PEFR compared to baseline (L/min) Show forest plot	3	393	Mean Difference (IV, Fixed, 95% CI)	‐2.31 [‐12.53, 7.91]

4 Change in PEFR predicted (%) Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

5 Beta‐agonist use (puffs/day) Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

6 Beta‐agonist use (% reduction in days using beta‐agonist) Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

7 Change in rescue medication usage (Juniper questionnaire item 6) Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

8 Change in asthma‐free days per week Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

9 Change in % days without asthma symptoms Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

10 Change in heath‐related quality of life (AQLQ) Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

11 Change in health‐related quality of life (ACQ) Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

12 Withdrawals (any reason) Show forest plot	6	1011	Risk Ratio (M‐H, Fixed, 95% CI)	0.73 [0.47, 1.14]

13 Dysphonia Show forest plot	2	496	Risk Ratio (M‐H, Fixed, 95% CI)	1.53 [0.92, 2.54]

14 Headache Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

15 Increased asthma symptoms Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

16 Oral candidiasis Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

17 Any adverse event Show forest plot	3	668	Risk Ratio (M‐H, Fixed, 95% CI)	0.88 [0.72, 1.08]

18 Admission to hospital for asthma Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

Comparison 1. FP versus HFA‐BDP (dose ratio 1:1; parallel group trials)

Ir a la tabla de la revisión

Comparison 2. FP versus HFA‐BDP (dose ratio 1:1; crossover trials)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 FEV1 (predicted) Show forest plot	2	100	% (Fixed, 95% CI)	‐0.09 [‐5.02, 4.84]

2 Morning PEFR Show forest plot	1		Litres/min (Fixed, 95% CI)	Totals not selected

3 Asthma Control Questionnaire Show forest plot	1		Mean Difference (Fixed, 95% CI)	Totals not selected

4 Growth (cm) Show forest plot	1		Mean Difference (Fixed, 95% CI)	Totals not selected

Comparison 2. FP versus HFA‐BDP (dose ratio 1:1; crossover trials)

Ir a la tabla de la revisión

The Cochrane Library

Scolaris Language Selector Scolaris Language Selector

Idioma de la Revisión Cochrane

Idioma de la web

Scolaris Content Language Banner Portlet Scolaris Content Language Banner Portlet