Table H-15Strength of evidence for the comparative efficacy of LTRA + ICS and LABA + ICS

Number of studies (# of subjects)DesignQualityConsistencyDirectnessMagnitude of effectOther modifying factorsOverall strength of evidence
Overall total: LTRA plus ICS compared with LABA plus ICS
1 (6,030)

8 (5,459)
1 SR w/MA

8 RCTs

Good (1); Fair (7)
ConsistentDirectICS+LABA > ICS+LTRA

Exacerbations requiring systemic steroids (RR 0.83; 95% CI: 0.71, 0.97)a
ML + FP compared with SM + FP
7 (5,411)RCTsGood (1) Fair (6)ConsistentDirectICS+LABA > ICS+LTRA for most reported outcomesNoneHigh
ML + BUD compared with FM + BUD
1 (48)RCTFairNADirectFM+BUD > ML+BUDNoneModerate

Abbreviations: BUD = Budesonide; CI = confidence interval;; FM = Formoterol; FP = Fluticasone Propionate; ICS = Inhaled Corticosteroids; LABAs = Long-Acting Beta-2 Agonists; LTRAs = Leukotriene receptor antagonists; MA=meta-analysis; RCT= randomized controlled trial; SM = Salmeterol; SR=systematic review.

From: Appendix H, Strength of evidence

Cover of Drug Class Review: Controller Medications for Asthma
Drug Class Review: Controller Medications for Asthma: Final Update 1 Report [Internet].
Jonas DE, Wines RCM, DelMonte M, et al.
Portland (OR): Oregon Health & Science University; 2011 Apr.
Copyright © 2011 by Oregon Health & Science University.

NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.