Research objectives

Inhaled steroids form the main treatment for chronic asthma but there are still large areas of uncertainty about their use. These include: the relative efficacy of the different drugs; influence of delivery systems; comparisons with other prophylactic therapies; comparison with long acting beta-agonists; differences between adults and children; effect of duration of therapy on response size; early vs. later introduction of therapy; dose-response relationships.

Large numbers of individual randomised controlled trials that address many of these issues have been performed, but there have been no systematic reviews of this treatment, in which all the available evidence has been drawn together into one body of material using an explicit set of rules and objective methods of data aggregation to produce an overall conclusion. Of two recently produced sets of guidelines for asthma management, one was produced by consensus; the other used an evidence-based but not systematic review based approach.

A range of systematic reviews is therefore being carried out within the Airways Group of the Cochrane Collaboration. The project will assemble the best available evidence concerning a wide range of aspects of inhaled steroid use. This information will aid the production of guidelines and formularies and provide the practising clinician with a comprehensive synthesis of all the evidence concerning the efficacy and application of this therapy. The reviews will also highlight areas where more research is required and provide data for power calculations for future studies.

For further information contact

Professor Paul Jones
Professor of Respiratory Medicine
Department of Medicine
Division of Physiological Medicine
St. George's Hospital Medical School
Jenner Wing
Cranmer Terrace
London, SW17 0RE
UK.

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