Table 4 Exacerbations requiring oral corticosteroids
Drug | Time period | na | Number of patients with exacerbations requiring OCS, n/N (%) | Exacerbations requiring OCSb | |
|---|---|---|---|---|---|
Active treatment | Comparator | Risk ratio (95% CI) | |||
Cochrane analysis of LABA studies (Chauhan 2015) | 1669 | 0.95 (0.70, 1.28) | |||
Formoterol added to ICS versus ICS | |||||
Eid 2010 Budesonide/formoterol 160/18 μg daily vs budesonide 160 μg QD | 12 weeks | 267 | 15/183 (8.2) | 13/84 (15.5) | 0.53 (0.26, 1.06) |
Eid 2010 Budesonide/formoterol 160/9 μg daily vs budesonide 160 μg daily | 12 weeks | 252 | 33/168 (19.6) | 13/84 (15.5) | 1.27 (0.71, 2.28) |
Salmeterol added to ICS versus ICS | |||||
Langton Hewer 1995 Salmeterol 100 μg BID add-on to usual ICS (baseline mean 400 μg) | 8 weeks | 23 | 3/11 (27.2) | 3/12 (25.0) | 1.09 (0.28, 4.32) |
Lenney 2013 Fluticasone propionate/salmeterol 100/50 μg BID vs fluticasone propionate 100 μg BID | 48 weeks | 26 | 5/15 (33.3) | 1/11 (9.1) | 3.67 (0.50, 27.12) |
Malone 2005 Salmeterol/fluticasone 50/100 μg BID vs fluticasone 100 μg BID | 3 months | 203 | 2/101 (2.0) | 3/102 (2.9) | 0.67 (0.11, 3.94) |
Murray 2011 Salmeterol/fluticasone 50/100 μg BID vs fluticasone 100 μg BID | 4 weeks | 231 | 2/113 (1.8) | 1/118 (0.8) | 2.09 (0.19, 22.71) |
Pearlman 2009 Salmeterol/fluticasone 50/100 μg BID vs fluticasone 100 μg BID | 4 weeks | 248 | 1/124 (0.8) | 1/124 (0.8) | 1.00 (0.06, 15.81) |
Simons 1997 Salmeterol 50 μg QD add-on to BDP 200–400 μg/day | 4 weeks | 32 | 0/16 (0.0) | 1/16 (6.3) | 0.33 (0.01, 7.62) |
Verberne 1998 Salmeterol/BDP 50/200 μg BID vs BDP 200 μg BID | 54 weeks | 117 | 10/60 (16.7) | 10/57 (17.5) | 0.95 (0.43, 2.11) |
Russell 1995 Salmeterol 50 μg BID add-on to ICS 400–2400 μg/day | 12 weeks | 198 | 16/99 (16.2) | 18/99 (18.2) | 0.89 (0.48, 1.64) |
Tiotropium added to ICS versus ICS | Hazard ratio (95% CI) | ||||
Hamelmann 2016 Tiotropium 5 μg add-on to 400–800 μg/day budesonide (200–800 μg/day for patients aged 12–14 years) | 48 weeks | 272 | 2/134 (1.5) | 9/138 (6.5) | 0.23 (0.05, 1.08)c |
Hamelmann 2016 Tiotropium 2.5 μg add-on to 400–800 μg/day budesonide (200–800 μg/day for patients aged 12–14 years) | 48 weeks | 263 | 5/125 (4.0) | 9/138 (6.5) | 0.63 (0.21, 1.87)c |
Vogelberg 2018 Tiotropium 5 μg add-on to 200–400 μg budesonide | 48 weeks | 266 | 7/135 (5.2) | 6/131 (4.6) | 1.14 (0.38, 3.39)c |
Vogelberg 2018 Tiotropium 2.5 μg add-on to 200–400 μg budesonide | 48 weeks | 266 | 7/135 (5.2) | 6/131 (4.6) | 1.14 (0.38, 3.38)c |
Tiotropium added to ICS plus other controller(s) versus ICS plus other controller(s) | |||||
Hamelmann 2017 Tiotropium 5 μg add-on to high-dose ICSd + ≥1 controller or medium-dose ICSe + ≥2 controllers | 12 weeks | 265 | 2/130 (1.5) | 1/135 (0.7) | 2.06 (0.19, 22.70)c |
Hamelmann 2017 Tiotropium 2.5 μg add-on to high-dose ICSd + ≥1 controller or medium-dose ICSe + ≥2 controllers | 12 weeks | 262 | 1/127 (0.8) | 1/135 (0.7) | 1.06 (0.07, 16.95)c |
Szefler 2017 Tiotropium 5 μg add-on to > 400 μg budesonide + ≥1 controller or 200–400 μg budesonide + ≥2 controllers | 12 weeks | 264 | 7/130 (5.4) | 8/134 (6.0) | 1.01 (0.35, 2.88)c |
Szefler 2017 Tiotropium 2.5 μg add-on to > 400 μg budesonide + ≥1 controller or 200–400 μg budesonide + ≥2 controllers | 12 weeks | 270 | 3/136 (2.2) | 8/134 (6.0) | 0.40 (0.10, 1.55)c |
Montelukast added to ICS versus ICS | |||||
Castro-Rodriguez 2010 systematic review Montelukast 5 mg add-on to 200–800 μg/day budesonide | NR | NR | NR | NR | Risk ratio (95% CI) 0.53 (0.10, 2.74)f |
Zhao 2015 network meta-analysis Montelukast 4–10 mg add-on to 100–200 μg/day budesonide | 4–16 weeks | NR | NR | NR | Odds ratio (95% CI) 0.94 (0.58, 1.45) |
Stelmach 2015 Montelukast 5 mg add-on to 200–600 μg budesonideg | 7 months | 76 | NR | NR | Odds ratio (95% CI) 0.26 (0.09, 0.76) |