title: The Effectiveness of Anti-leukotriene Agents in Patients with COPD: A Systemic Review and Meta-analysis.
abstract: BACKGROUND
  Anti-leukotriene (anti-LT) agents have been not yet established for effectiveness in patients with chronic obstructive pulmonary disease (COPD). We performed a systematic review and meta-analysis to assess whether anti-LT agents have the responsiveness for COPD patients.
  
  
  METHODS
  MEDLINE, EMBASE, Cochrane Central Register, and Korea Med were searched for relevant clinical trials to review.
  
  
  RESULTS
  Seven studies involving 342 patients were finally analyzed. Pooled estimation from three randomized controlled studies did not demonstrate that anti-LT agents increased forced expiratory volume in 1 s [overall effect: 0.09 L, 95 % confidence interval (CI) -0.04 to 0.21; P = 0.17; I (2)  = 41.0 %] or forced vital capacity (overall effect: 0.04 L, 95 % CI -0.04 to 0.11; P = 0.64; I (2) = 0.0 %). As for inflammatory markers, anti-LT agents did not affect the level of myeloperoxidase (standardized mean difference, -0.15; 95 % CI -0.65 to 0.36) or LTB4 (standardized mean difference, -0.41; 95 % CI -0.96 to 0.13). They reduced the frequency of dyspnea [relative risk (RR) 0.43; 95 % CI 0.29 to 0.64] and sputum (RR 0.37; 95 % CI 0.22 to 0.63), based on overall estimation from two non-randomized studies. However, our review revealed that there are few well-designed, randomized controlled studies with large sample sizes and long treatment durations.
  
  
  CONCLUSIONS
  Although symptomatic improvements were demonstrated in some studies, there is a lack of evidence to support the therapeutic efficacy of anti-LT agents in patients with COPD. Further large-scale, long-term studies are needed to identify predictive factors for COPD patients who may benefit from anti-LT agents.
authors.affiliation: Department of Internal Medicine, School of Medicine, Jeju National University Hospital, Jeju National University, Jeju City, Korea.
authors.forename: Jong Hoo
authors.initials: JH
authors.lastname: Lee
authors.forename: Hyun Jung
authors.initials: HJ
authors.lastname: Kim
authors.forename: Yee Hyung
authors.initials: YH
authors.lastname: Kim
mesh_terms: D004417:Dyspnea / Q000188:drug therapy; D005541:Forced Expiratory Volume / Q000187:drug effects; D006801:Humans; D020024:Leukotriene Antagonists / Q000627:therapeutic use*; D010102:Oxygen Inhalation Therapy; D009195:Peroxidase / Q000097:blood; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000503:physiopathology / Q000628:therapy; D016032:Randomized Controlled Trials as Topic; D013183:Sputum / Q000187:drug effects; D014797:Vital Capacity / Q000187:drug effects
chemical_list: D020024:Leukotriene Antagonists; D009195:Peroxidase