Evidence map›Paper›PMID 37927455›Full record

SynthesisCanadian journal of respiratory therapy : CJRT = Revue canadienne de la therapie respiratoire : RCTR2023

The effectiveness of hyaluronic acid in reducing adverse effects associated with inhaled hypertonic saline therapy in patients with cystic fibrosis: A systematic review and meta-analysis.

Sana Arshid, Saad Ehsan Ullah, Junaid Imran, Meeran Asher Syed, Aakash Choradia, Nicole Gousy, Sukhman Boparai, Mudassir Shoaib, Bidhan Bikram Shah, Aadarsh Netha

Open access · diamondAbstract readSystematic Review
In one paragraph

Synthesis in Canadian journal of respiratory therapy : CJRT = Revue canadienne de la therapie respiratoire : RCTR, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.5field-weighted citation impact, top 28% of its field
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

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Recent Use of Hyaluronic Acid in Dental Medicine.Materials (Basel, Switzerland) · 2025
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 8 institutions in 4 countries.

Sana ArshidDepartment of Medicine Shaikh Zayed Hospital.ORCID https://orcid.org/0009-0008-5254-898X
Saad Ehsan UllahDepartment of Medicine Shaikh Zayed Hospital.ORCID https://orcid.org/0000-0001-6329-1085
Junaid ImranDepartment of Medicine Khyber Medical College.ORCID https://orcid.org/0000-0001-6765-850X
Meeran Asher SyedDepartment of Internal Medicine Fauji Foundation Hospital.ORCID https://orcid.org/0009-0008-7580-5651
Aakash ChoradiaDepartment of Medicine Tribhuwan University.ORCID https://orcid.org/0009-0006-8791-6397
Nicole GousyDepartment of Medicine American University of Antigua.ORCID https://orcid.org/0000-0002-6356-2102
Sukhman BoparaiDepartment of Medicine Acharya Shri Chander College of Medical Sciences and Hospital.ORCID https://orcid.org/0000-0002-9831-1522
Mudassir ShoaibDepartment of Medicine Jinnah Medical & Dental College.ORCID https://orcid.org/0000-0001-8931-6826
Bidhan Bikram ShahDepartment of Medicine Kathmandu Medical College.ORCID https://orcid.org/0000-0002-8616-2304
Aadarsh NethaDepartment of Medicine Melmaruvathur Adhiparasakthi Institute of Medical Sciences and Research.ORCID https://orcid.org/0009-0005-8687-2831
Shaikh Zayed Hospital · PKAcharya Shri Chander College of Medical Sciences and Hospital · INAmerican University of Antigua · AGInstitute of Medical Sciences · INJinnah Medical & Dental College · PKKathmandu Medical College Teaching Hospital · NPKhyber Medical College · PKTribhuvan University · NP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Inhaled hypertonic saline (HS) is an effective mucolytic agent in patients with cystic fibrosis (CF). However, adverse events can impair the clinical utility of hypertonic saline (HS) in this patient population. In this study, we aimed to investigate the effectiveness of hyaluronic acid (HA) in reducing these adverse events. Methods: A literature search was conducted across three electronic databases (Medline, Cochrane Central, and EMBASE) from inception through February 2023. Randomized controlled trials (RCTs) assessing the impact of hyaluronic acid (HA) in reducing adverse events in patients taking hypertonic saline (HS) for CF were included in the analysis. Outcomes of interest included cough, throat irritation, unpleasant taste, and FEV1. Evaluations were reported as risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CI). The Cochrane Risk of Bias Tool (CRBT) was employed to assess the quality of RCTs. The New Castle Ottawa Scale was used to assess the quality of observational studies. Results: From the 1960 articles retrieved from the initial search, five relevant studies (n=236 patients) were included in the final analysis. Compared with patients only on HS, patients with HS and HA were significantly less likely to experience cough (RR: 0.45; 95% CI, 0.28-0.72, Discussion: The addition of HA to HS was linked to a better tolerability profile. When HS was coupled with HA, there was a reduction in all side effects. This may permit tolerance of the medication in otherwise difficult patients, improve adherence to patients receiving frequent inhalations, and improve therapeutic outcomes. Conclusion: The addition of HA is advantageous in CF patients who require continuous HS therapy and have previously shown poor tolerance to therapy.

Indexed as

Cystic FibrosisExpectorantsHyaluronic AcidHypertonic Saline

Identifiers

PMID37927455
PMCPMC10621800
OpenAlexW4388079500

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.