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We read with interest the meta-analysis by Masoli et al1 which aimed to further guide clinicians in their choice between addition of long acting β2 agonists (LABA) or use of higher doses of inhaled corticosteroids (ICS) in patients with symptomatic asthma. The pooled odds of at least one moderate or severe exacerbation was 1.35 times higher in those receiving a higher dose of ICS than in those treated with LABA.
Unfortunately, it is difficult to draw any meaningful conclusion as to the clinical relevance of these findings or to compare at a glance the results with those of the previous MIASMA study2 because of differences in the summary statistics presented. For clinicians to understand the clinical context of these two studies, it is helpful to calculate the number needed to treat (NNT), as was done in the original MIASMA study.
Of the 2312 patients randomised to LABA treatment included in the newer study, 184 …