Bronchoprotective effects of leukotriene receptor antagonists in asthma: a meta-analysis.
OBJECTIVE
Cysteinyl leukotrienes are important proinflammatory mediators in the pathogenesis of asthma. Since bronchial hyperresponsiveness is a noninvasive surrogate marker of asthmatic airway inflammation, we evaluated the bronchoprotection afforded by leukotriene receptor antagonists (LTRAs).


METHODS
Systematic review of randomized, placebo-controlled trials in which LTRAs were administered for >or= 5 days. Studies in which active drug was administered as a first-line or second-line therapy were used.


METHODS
MEDLINE, BIDS, and Cochrane Library data registers.


METHODS
The doubling dose/dilution difference that caused a 20% fall in the FEV(1) between LTRA and placebo.


RESULTS
Thirteen trials (353 subjects) fulfilled eligibility criteria. Combining the results the overall weighted estimated protection amounted to a 0.85 doubling dose shift (95% confidence interval, 0.69 to 1.02).


CONCLUSIONS
Since the estimated protection amounted to almost one doubling dose, this reinforces the role of LTRAs as anti-inflammatory therapy in asthma.
Asthma and Allergy Research Group, Department of Clinical Pharmacology and Therapeutics, Ninewells Hospital and Medical School, University of Dundee, Dundee, Scotland.
Graeme P
GP
Currie
Brian J
BJ
Lipworth
D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D016535:Bronchial Hyperreactivity / Q000503:physiopathology*; D001985:Bronchial Provocation Tests; D016001:Confidence Intervals; D006801:Humans; D020024:Leukotriene Antagonists / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic
D018927:Anti-Asthmatic Agents; D020024:Leukotriene Antagonists