Comparison of Moderate and Low Doses of ICSs in Terms of Clinical and Functional Benefits
| Study | ICS | Moderate vs Low Doses, μg/d | Improvements from baseline | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PEFAM, L/min or % Predicteda | PEFPM, L/min or % Predicteda | FEV1, L or % Predictedb | Symptom Score | β2-Agonist Use, Puffs per d | ||||||||
| Mean, SE | SMD (95% CI) | Mean (SE) | SMD (95% CI) | Mean (SE) | SMD (95% CI) | Mean (SE) | WMD (95% CI) | Mean (SE) | WMD (95% CI) | |||
| Allen et al15 (1998) | FLU Diskhaler | 200 vs 100 | — | — | — | — | 0.25 (0.03) vs 0.20 (0.02) | 0.20 (−007 to 0.47) | — | — | — | — |
| Katz et al14 (1998) | FLU DPI | 200 vs 100 | 57 (3.9) vs 50 (5.0) | 0.17 (−0.13 to 0.47) | 53 (3.9) vs 44 (4.0) | 0.24 (−0.06 to 0.54) | 0.25 (0.03) vs 0.17 (0.03) | 0.29 (−0.02 to 0.59) | −0.44 (0.06) vs −0.43 (0.08) | −0.01 (−0.21 to 0.19) | −1.14 (0.19) vs −0.73 (0.16) | −0.41 (−0.91 to 0.09) |
| Peden et al16 (1998) | FLU Diskus | 200 vs 100 | 40 (5.0) vs 34 (3.0) | 0.16 (−0.14 to 0.45) | 34 (4.0) vs 26 (3.0) | 0.24 (−0.05 to 0.54) | 0.24 (0.03) vs 0.22 (0.03) | 0.08 (−0.24 to 0.39) | −0.41 (0.07) vs −0.36 (0.07) | −0.05 (−0.24 to 0.14) | −1.04 (0.19) vs 0.08 (0.23) | −1.12 (−1.71 to −0.52) |
| Peden et al16 (1998) | FLU Diskhaler | 200 vs 100 | 42 (4.0) vs 41 (5.0) | 0.02 (−0.28 to 0.32) | 36 (4.0) vs 36 (4.0) | 0.0 (−0.29 to 0.29) | 0.23 (0.04) vs 0.24 (0.03) | −0.03 (−0.35 to 0.29) | −0.36 (0.07) vs −0.41 (0.07) | 0.05 (−0.14 to 0.25) | −0.90 (0.23) vs −1.02 (0.18) | 0.12 (−0.45 to 0.69) |
| Shapiro et al12 (2001) | BUD Turbuhaler | 400 vs 200 | 1.3 (1.3) vs 2.9 (1.3) | −0.13 (−0.42 to 0.16) | 2.4 (1.3) vs 1.8 (1.2) | 0.05 (−0.24 to 0.34) | 2.7 (1.6) vs 2.3 (1.6) | 0.03 (−0.26 to 0.32) | — | — | — | — |
| Nayak et al13 (2002) | BDP HFA Autohaler | 160 vs 80 | — | — | — | — | 10.1 (1.2) vs 9.1 (1.1) | 0.08 (−0.18 to 0.33) | — | — | −0.58 (0.12) vs −0.26 (0.18) | −0.32 (−0.74 to 0.10) |
| Skoner et al17 (2008) | CIC HFA MDI | 160 vs 40 | — | — | — | — | 0.15 (0.01) vs 0.13 (0.01) | 0.11 (−0.08 to 0.29) | — | — | — | — |
| Pooled result | — | — | 0.05 (−0.09 to 0.20) | 0.13 (−0.02 to 0.28) | 0.11 (0.01 to 0.21) | −0.003 (−0.12 to 0.11) | −0.42 (−0.87 to 0.03) | |||||
FLU indicates fluticasone; BUD, budesonide; HFA, hydrofluoroalkane; CIC, ciclesonide; —, not available/applicable.
↵a PEFAM and PEFPM were measured as percent predicted by Shapiro et al12 and L/min by Katz et al14 and Peden et al.16
↵b FEV1 was measured as percent predicted by Nayak et al13 and Shapiro et al12 and liters by Allen et al,15 Katz et al,14 Peden et al,16 and Skoner et al.17