SynthesisBMJ open2020
Impact of smoking status on the efficacy of inhaled corticosteroids in chronic obstructive pulmonary disease: a systematic review.
Synthesis in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled 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.
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.
Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Real-World Effectiveness of Triple Extrafine Fixed-Dose Combination with Beclomethasone/Formoterol/Glycopyrronium on Symptoms and Lung Function in COPD: A Systematic Review and Meta-Analysis.International journal of chronic obstructive pulmonary disease · 2025Pooled it
- Reply to BardsleyAmerican journal of respiratory and critical care medicine · 2025Article
- Chronic Obstructive Pulmonary Disease (COPD): Developments in Pharmacological Treatments.Drugs · 2025Review
- Tobacco smoking and sarcoidosis revisited-Evidence, mechanisms, and clinical implications: a narrative review.Current medical research and opinion · 2025Review
- Pharmacologic Therapies for Preventing Chronic Obstructive Pulmonary Disease Exacerbations: A Comprehensive Review.Tuberculosis and respiratory diseases · 2025Article
- A Delphi Consensus Project to Capture Greek Experts' Opinion on the Position of Triple Therapies in COPD: Why, When and to Whom.International journal of chronic obstructive pulmonary disease · 2025Article
- Decreased Sputum Type-2 Gene Expression in COPD Current Smokers.International journal of chronic obstructive pulmonary disease · 2025Article
- Association of blood eosinophils with corticosteroid treatment failure stratified by smoking status among inpatients with AECOPD.BMJ open respiratory research · 2024Article
- Analysis of Key Genes and miRNA-mRNA Networks Associated with Glucocorticoids Treatment in Chronic Obstructive Pulmonary Disease.International journal of chronic obstructive pulmonary disease · 2024Article
- Current smoking reduces small airway eosinophil counts in COPD.ERJ open research · 2024Article
- Efficacy and Safety of Umeclidinium/Vilanterol in Current and Former Smokers with COPD: A Prespecified Analysis of The EMAX Trial.Advances in therapy · 2021Article
- ACO (Asthma-COPD Overlap) Is Independent from COPD: The Case in Favour.Diagnostics (Basel, Switzerland) · 2021Review
- Corticosteroid Resistance in Smokers-A Substudy Analysis of the CORTICO-COP Randomised Controlled Trial.Journal of clinical medicine · 2021Article
- Predictors of Single Bronchodilation Treatment Response for COPD: An Observational Study with the Trace Database Cohort.Journal of clinical medicine · 2021Article
- Efficacy of indacaterol/glycopyrroniumERJ open research · 2021Article
- Clinical factors linked to the type of respiratory medication in COPD: results from the COSYCONET cohort.Therapeutic advances in respiratory diseaseArticle
- Stepwise management of COPD: What is next after bronchodilation?Therapeutic advances in respiratory diseaseReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesInhaled corticosteroids (ICS) reduce exacerbation rates and the decline in lung function in people with chronic obstructive pulmonary disease (COPD). There is evidence that smoking causes 'steroid resistance' and thus reduces the effect of ICS. This systematic review aimed to investigate the effect of smoking on efficacy of ICS in COPD in terms of lung function and exacerbation rates.
designSystematic review. DATA SOURCES: An electronic database search of PubMed, Ovid MEDLINE, Ovid Embase and Cochrane Library (January 2000 to January 2020). ELIGIBILITY CRITERIA: Fully published randomised controlled trials (RCTs), in the English language, evaluating the use of ICS in COPD adults that stratified the participants by smoking status. Trials that included participants with asthma, lung cancer and pneumonia were excluded. The primary outcome measures were changes in lung function and yearly exacerbation rates. DATA EXTRACTION AND SYNTHESIS: Two independent reviewers extracted data and assessed risk of bias using the Cochrane Collaboration's tool.
resultsSeven studies were identified. Four trials (17 892 participants) recorded change in forced expiratory volume in one second (FEV
conclusionsIn COPD, heavier or current smokers do not gain the same benefit from ICS use on lung function and exacerbation rates as lighter or ex-smokers do, however effects may not be clinically important. PROSPERO REGISTRATION NUMBER: CRD42019121833.
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Registered trials
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.