| Comparison 6. Continuous alternating therapy versus intermittent treatment: aztreonam + tobramycin or placebo + tobramycin | ||||||
|---|---|---|---|---|---|---|
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Intermittent treatment: aztreonam lysine + tobramycin or placebo + tobramycin | Continuous alternating therapy | |||||
| Lung function: % change in FE1% predicted Scale from: 0 to 100 Follow-up: 20 weeks1 | The mean % change in FEV1% predicted in the intermittent treatment groups was 0.04 | The mean % change in FEV1% predicted in the continuous alternating therapy groups was 1.33 higher (1.05 to 1.61 higher) | 88 (Flume 2016) | ⊕⊕⊕⊝ moderate2 | ||
| Time to next pulmonary exacerbation | - | - | HR 0.89 (0.49 to 1.6) | 88 (Flume 2016) | ⊕⊕⊝⊝ low2,3 | |
| Quality of life: change in CFQ-R Scale from: 0 to 100 Follow-up: 20 weeks1 | The mean change in CFQ-R in the intermittent treatment groups was −2.06 | The mean change in CFQ-R in the continuous alternating therapy groups was 3.06 higher (2.35 to 3.77 higher) | 88 (Flume 2016) | ⊕⊕⊝⊝ low2,4 | ||
| Minor adverse events: cough Follow-up: 3 months | 435 per 1000 | 761 per 1000 (526 to 1000) | RR 1.75 (1.21 to 2.54) | 88 (Flume 2016) | ⊕⊕⊝⊝ low2,5 | |
| Serious adverse events: dyspnoea Follow-up: 3 months | 522 per 1000 | 308 per 1000 (183 to 527) | RR 0.59 (0.35 to 1.01) | 88 (Flume 2016) | ⊕⊕⊝⊝ low2,5 | |
| Serious adverse events (not treatment related) Follow-up: 3 months | 522 per 1000 | 501 per 1000 (334 to 751) | RR 0.96 (0.64 to 1.44) | 88 (Flume 2016) | ⊕⊝⊝⊝ very low2,6 | |
The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
Abbreviations: CFQ-R: cystic fibrosis questionnaire reviewed; CI: confidence interval; FEV1: forced expiratory volume in 1 second; MD: mean difference; mg: milligrams; RR: risk ratio
Values at 4, 12 and 20 weeks were averaged
The quality of the evidence was downgraded by 1 due to unclear allocation concealment, blinding, and data collection/reporting
The quality of the evidence was downgraded by 1 as the 95% CI crossed the null effect line
The quality of the evidence was downgraded by 1 as the 95% CI crossed 1 clinical MID
The quality of the evidence was downgraded by 1 as the 95%CI crossed 1 default MID
The quality of the evidence was downgraded by 2 as the 95%CI crossed 2 default MIDs
From: 9, Pulmonary monitoring, assessment and management
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