On-Demand Inhaled Corticosteroid and Fast-Acting Beta-2 Agonist Combination Therapy Versus Regular Inhaled Corticosteroid Plus Rescue Bronchodilator in Adults with Mild Asthma: A Network Meta-Analysis

Abstract

: The aim of this study was to assess the non-inferiority of on-demand OD inhaled corticosteroid ICS and fast-acting beta-2 agonist FABA combination therapy. Although regular inhalation of low-dose ICS and OD short-acting beta-2 agonist REG-ICS OD-SABA is said to be effective therapy for mild asthma, we investigated whether OD-ICS / FABA is as effective as REG-ICS OD-SABA. A network meta-analysis of randomized controlled trials was conducted to examine non-inferiority by comparing the ef cacy of NON-REG OD-ICS / FABA with REG-ICS OD-SABA for mild asthma. We also assessed the superiority of NON-REG OD-ICS / FABA to OD-SABA without any regular treatment NON-REG OD-SABA . PubMed, the Cochrane library database, and Scopus were searched to identify relevant articles with an outcome measure of the incidence of asthma control. A network meta-analysis was performed and the summary effect size was expressed as the mean difference MD with 95 con dence intervals CIs . The probability of being the best treatment for the outcome and the surface under the cumulative ranking curves were also calculated. Three randomized controlled trials of treatment for mild asthma met the criteria and were included in the study. Non-inferiority of NON-REG OD-ICS / FABA to REG-ICS OD-SABA MD, 0.17 ; 95 CI, 0.41 to 0.07 and superiority of NON-REG OD-ICS / FABA to NON-REG OD-SABA MD, 0.29 ; 95 CI, 0.49 to 0.08 were shown in patients with mild asthma. The respective probabilities of being the best treatment for asthma control were 91.2 , 8.8 and 0.2 for NON-REG OD-ICS / FABA, REG-ICS OD-SABA, and NON-REG OD-SABA, respectively, and the surface under the cumulative ranking curves were 1.0, 0.5, and 0.1, respectively. These results suggest that NON-REG OD-ICS / FABA is an effective alternative to REG-ICS OD-SABA for asthma control in patients with mild asthma.