The following is a summary of “Systematic literature review of traits and outcomes reported in randomized controlled trials of asthma with regular dosing of inhaled corticosteroids with a short-acting β2-agonist reliever, as-needed ICS/formoterol, or ICS/formoterol maintenance and reliever therapy,” published in the January 2024 issue of Pulmonology by Roche, et al.
Asthma treatments based solely on diagnostic labels often yield varying benefits among patients. For a study, researchers sought to identify patient characteristics associated with improved treatment response to regular inhaled corticosteroids (ICSs) dosing with short-acting β2-agonist (SABA) relievers or ICS/formoterol-containing therapy.
A comprehensive search of databases, including MEDLINE and Embase, was performed to identify randomized controlled trials (RCTs) involving patients with asthma aged ≥12 years, published between 1998 and 2022. Eligible trials contained at least one arm receiving regular ICS dosing or ICS/formoterol-containing treatment and reported patient characteristics and outcomes of interest. Relevant data were extracted, and a feasibility assessment was undertaken to determine suitability for meta-analysis.
The SLR identified 39 RCTs involving 72,740 patients and 90 treatment arms, reporting on 11 patient characteristics and 11 outcomes. Among these, five patient characteristics (age, body mass index, FEV1 , smoking history, asthma control) and five outcomes (exacerbation rate, lung function, asthma control, adherence, time to first exacerbation) were deemed feasible for inclusion in meta-analyses due to sufficient comparable reporting. Subgroups of clinical outcomes stratified by levels of patient characteristics were reported in 16 RCTs.
The systematic review of studies investigating regular ICS dosing with SABA or ICS/formoterol-containing treatment strategies in asthma revealed consistent reporting of five patient characteristics and outcomes, enabling exploration of associations with treatment response. However, many other potentially relevant characteristics and outcomes needed to be more consistently reported, and more subgroup reporting hindered analyses of treatment response for trait subgroups. Thus, they recommended more consistent measurement and reporting of clinically relevant patient characteristics and outcomes in respiratory RCTs.
Reference: resmedjournal.com/article/S0954-6111(23)00366-9/fulltext