Systematic review —a tool for the pharmaceutical physician

  • Stephen B. Shrewsbury
Original Article


A meta-analysis of nine large clinical studies that had looked at a clinical dilemma, which option to use at ‘Step 3 of the British Guidelines on Asthma Management’, was conducted to attempt to determine the better option for adult asthma. All studies had reported results demonstrating superiority of the addition of a long-acting bronchodilator to inhaled corticosteroid for lung function, but, taken singly, none of the studies had sufficient power to provide conclusive evidence on the relative effect of either treatment option on the incidence of asthma exacerbations. However, a carefully conducted meta-analysis of the nine studies was able to provide a conclusive answer to this question. The work was further developed after abstract presentation and subsequently published. This article argues that the pharmaceutical physician is well placed to use this statistical tool more often, but still judiciously, to look at the benefit (or risk) of drugs in development or on the market, and then to act upon that information appropriately.


asthma exacerbation inhaled corticosteroids long-acting bronchodilator meta-analysis salmeterol 



This work was submitted in full to the Faculty of Pharmaceutical Medicine, UK, in March 2001 as a dissertation for full faculty membership. This article represents a summary of the work undertaken and the discussion. The views expressed are those of the author. The author would like to thank Stephen Pyke and Mark Britton for their help with MIASMA and Stuart Dollow, FFPM, for his comments and advice on this article.


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Copyright information

© Lippincott Williams & Wilkins 2002

Authors and Affiliations

  1. 1.Clinical Development & Medical AffairsGlaxoSmithKlineUSA

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