Evidence map›Paper›PMID 42688694›Full record

ArticleCHEST pulmonary2026

Medium-Dose Compared With High-Dose Inhaled Corticosteroids in Combination Triple Inhaler Therapy for Asthma: A Systematic Review and Meta-Analysis.

Samantha Warhurst, Ryan Cullen, Ross Sayers, Francesca Lynch, Joseph Kulathinal, Mark Weatherall, Richard W Beasley, Jonathan H Noble

Abstract read
In one paragraph

Article in CHEST pulmonary, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

8 authors.

Samantha WarhurstMedical Research Institute of New Zealand, Wellington, New Zealand.
Ryan CullenMedical Research Institute of New Zealand, Wellington, New Zealand.
Ross SayersMedical Research Institute of New Zealand, Wellington, New Zealand.
Francesca LynchMedical Research Institute of New Zealand, Wellington, New Zealand.
Joseph KulathinalMedical Research Institute of New Zealand, Wellington, New Zealand.
Mark WeatherallUniversity of Otago, Wellington, New Zealand.
Richard W BeasleyMedical Research Institute of New Zealand, Wellington, New Zealand.
Jonathan H NobleMedical Research Institute of New Zealand, Wellington, New Zealand.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Combination inhaled corticosteroid (ICS)/long-acting beta Research Question: What is the clinical effect of HD compared with MD ICSs in ICS/LABA/LAMA treatment of asthma? Study Design and Methods: A systematic review and meta-analysis of randomized controlled trials including > 1 ICS dose in ICS/LABA/LAMA inhalers compared the outcomes of HD and MD ICS/LABA/LAMA. The primary outcome was the proportion of participants with ≥ 1 severe asthma exacerbations. Secondary outcomes included FEV Results: Three randomized controlled trials (N = 3,804) were identified, comparing MD and HD ICS/LABA/LAMA containing fluticasone or mometasone. When comparing HD with MD ICS/LABA/LAMA for at least 1 severe exacerbation, the Peto OR was 0.81 (95% CI, 0.68-0.96; Interpretation: Our results show that HD compared with MD ICS/LABA/LAMA reduces the odds of a severe exacerbation by about 20%. This absolute risk reduction was modest but may be clinically relevant for patients with high baseline exacerbation rates and those with high type 2 inflammation. At both the individual and population level, the use of HD ICS/LABA/LAMA needs to be considered alongside the potential systemic side effects. Clinical Trial Registration: PROSPERO Registry; No.: CRD42025634340; URL: https://www.crd.york.ac.uk/prospero/.

Indexed as

asthmacombination triple inhaler therapycorticosteroid stewardshipdose responseinhaled corticosteroids

Identifiers

PMID42688694
PMCPMC13534840

What Socratic holds

Textmetadata
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 Socratic graph.