Evidence map›Paper›PMID 16235315›Full record

SynthesisThe Cochrane database of systematic reviews2005

Fluticasone versus placebo for chronic asthma in adults and children.

N P Adams, J C Bestall, T J Lasserson, P W Jones, C Cates

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in The Cochrane database of systematic reviews, 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 22 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
37citing papers in PubMed, 22 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

37 citing papers in PubMed, 22 syntheses or guidelines pooled it, 42 citations in OpenAlex.

  1. Does the use of inhaled corticosteroids in asthma benefit lung function in the long-term? A systematic review and meta-analysis.European respiratory review : an official journal of the European Respiratory Society · 2021
    Pooled it
  2. Stepping down the dose of inhaled corticosteroids for adults with asthma.The Cochrane database of systematic reviews · 2017
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  18. Ciclesonide versus placebo for chronic asthma in adults and children.The Cochrane database of systematic reviews · 2008
    Pooled it
  19. Herbal interventions for chronic asthma in adults and children.The Cochrane database of systematic reviews · 2008
    Pooled it
  20. Nedocromil sodium for chronic asthma in children.The Cochrane database of systematic reviews · 2006
    Pooled it
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

N P Adams
J C Bestall
T J Lasserson
P W Jones
C Cates
St George's, University of London · GBSouthlands Hospital · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInhaled fluticasone propionate (FP) is a relatively new inhaled corticosteroid for the treatment of asthma.

objectives1. To assess efficacy and safety outcomes in studies that compared FP to placebo for treatment of chronic asthma.2. To explore the presence of a dose-response effect. SEARCH STRATEGY: We searched the Cochrane Airways Group Specialised Register (January 2005), reference lists of articles, contacted trialists and searched abstracts of major respiratory society meetings (1997-2004). SELECTION CRITERIA: Randomised trials in children and adults comparing FP to placebo in the treatment of chronic asthma. Two reviewers independently assessed articles for inclusion and methodological quality. DATA COLLECTION AND ANALYSIS: Two reviewers extracted data. Quantitative analyses were undertaken using RevMan 4.2 MAIN

resultsSeventy-five studies met the inclusion criteria (14,208 participants). Methodological quality was high. In non-oral steroid treated asthmatics with mild and moderate disease FP resulted in improvements from baseline compared with placebo across all dose ranges (100 to 1000 mcg/d) in FEV1 (between 0.13 to 0.45 litres); morning PEF (between 23 and 47 L/min); symptom scores (based on a standardised scale, between 0.5 and 0.85); reduction in rescue beta-2 agonist use (between 1.2 and 2.2 puffs/day). High dose FP increased the number of patients who could withdraw from prednisolone: FP 1000-1500 mcg/day Peto Odds Ratio 14.07 (95% CI 7.17 to 27.57). FP at all doses led to a greater likelihood of sore throat, hoarseness and oral Candidiasis. Twenty-one patients would need to be treated for one extra to develop Candidiasis (FP 500 mcg/day), whilst only three or four patients need to be treated to avoid one extra patient being withdrawn due to lack of efficacy at all doses of FP. AUTHORS'

conclusionsDoses of FP in the range 100-1000 mcg/day are effective. In most patients with mild-moderate asthma improvements with low dose FP are only a little less than those associated with high doses when compared with placebo. High dose FP appears to have worthwhile oral-corticosteroid reducing properties. FP use is accompanied by an increased likelihood of oropharyngeal side effects.

Indexed as

Administration, InhalationAdultAndrostadienesAnti-Asthmatic AgentsAsthmaChildDose-Response Relationship, DrugFluticasoneHumansRandomized Controlled Trials as TopicAndrostadienesAnti-Asthmatic AgentsFluticasone

Identifiers

PMID16235315
OpenAlexW4231325292

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.