title: Addition to inhaled corticosteroids of leukotriene receptor antagonists versus theophylline for symptomatic asthma: a meta-analysis.
abstract: BACKGROUND
  Inhaled corticosteroids (ICSs) are widely used in combination with second controller medications in the management of asthma in adults and children. There lacks a systematic comparison between addition of leukotriene receptor antagonists (LTRAs) and theophylline to ICS. The purpose of this meta-analysis was to evaluate the difference of the efficacy and safety profile of adding either LTRAs or theophylline to ICS in adults and children with symptomatic asthma.
  
  
  METHODS
  Randomised controlled trials (RCTs) published prior to November 2014 were acquired through systematically searching and selected based on the established inclusion criteria for publications. The data extracted from the included studies were further analyzed by a meta-analysis.
  
  
  RESULTS
  We included eight RCTs, of which six recruited adults and two recruited children aged 5 to 14 years. The primary outcomes were changes in lung function from baseline, including forced expiratory volume in the first second (FEV1) and peak expiratory flow (PEF). Overall, addition of LTRAs led to significantly better morning PEF {mean difference (MD) 16.94 [95% confidence interval (CI): 11.49-22.39] L/min, P<0.01} and FEV1 [MD 0.09 (95% CI: 0.03-0.15) L, P=0.005] as compared to addition of theophylline. There were no differences between the two treatments in terms of evening PEF, adverse events, rescue medication use and asthma exacerbation.
  
  
  CONCLUSIONS
  The combination of LTRA and ICS leads to modestly greater improvement in lung function than the combination of theophylline and ICS in the treatment of symptomatic asthma. Long-term trials are required to assess the efficacy and safety of these two therapies.
authors.affiliation: 1 Department of Respiratory Diseases, Zhujiang Hospital of Southern Medical University, Guangzhou 510282, China ; 2 Department of Pharmacy, The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, China ; 3 Department of Pharmacy, Zhujiang Hospital of Southern Medical University, Guangzhou 510282, China ; 4 Department of Respiratory Diseases, SUN Yat-sen Memorial Hospital, SUN Yat-sen University, Guangzhou 510120, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Chen
authors.affiliation: 1 Department of Respiratory Diseases, Zhujiang Hospital of Southern Medical University, Guangzhou 510282, China ; 2 Department of Pharmacy, The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, China ; 3 Department of Pharmacy, Zhujiang Hospital of Southern Medical University, Guangzhou 510282, China ; 4 Department of Respiratory Diseases, SUN Yat-sen Memorial Hospital, SUN Yat-sen University, Guangzhou 510120, China.
authors.forename: Ying-Bo
authors.initials: YB
authors.lastname: Kang
authors.affiliation: 1 Department of Respiratory Diseases, Zhujiang Hospital of Southern Medical University, Guangzhou 510282, China ; 2 Department of Pharmacy, The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, China ; 3 Department of Pharmacy, Zhujiang Hospital of Southern Medical University, Guangzhou 510282, China ; 4 Department of Respiratory Diseases, SUN Yat-sen Memorial Hospital, SUN Yat-sen University, Guangzhou 510120, China.
authors.forename: Li-Qing
authors.initials: LQ
authors.lastname: Wang
authors.affiliation: 1 Department of Respiratory Diseases, Zhujiang Hospital of Southern Medical University, Guangzhou 510282, China ; 2 Department of Pharmacy, The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, China ; 3 Department of Pharmacy, Zhujiang Hospital of Southern Medical University, Guangzhou 510282, China ; 4 Department of Respiratory Diseases, SUN Yat-sen Memorial Hospital, SUN Yat-sen University, Guangzhou 510120, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Li
authors.affiliation: 1 Department of Respiratory Diseases, Zhujiang Hospital of Southern Medical University, Guangzhou 510282, China ; 2 Department of Pharmacy, The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, China ; 3 Department of Pharmacy, Zhujiang Hospital of Southern Medical University, Guangzhou 510282, China ; 4 Department of Respiratory Diseases, SUN Yat-sen Memorial Hospital, SUN Yat-sen University, Guangzhou 510120, China.
authors.forename: Yu-Wen
authors.initials: YW
authors.lastname: Luo
authors.affiliation: 1 Department of Respiratory Diseases, Zhujiang Hospital of Southern Medical University, Guangzhou 510282, China ; 2 Department of Pharmacy, The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, China ; 3 Department of Pharmacy, Zhujiang Hospital of Southern Medical University, Guangzhou 510282, China ; 4 Department of Respiratory Diseases, SUN Yat-sen Memorial Hospital, SUN Yat-sen University, Guangzhou 510120, China.
authors.forename: Zhe
authors.initials: Z
authors.lastname: Zhu
authors.affiliation: 1 Department of Respiratory Diseases, Zhujiang Hospital of Southern Medical University, Guangzhou 510282, China ; 2 Department of Pharmacy, The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, China ; 3 Department of Pharmacy, Zhujiang Hospital of Southern Medical University, Guangzhou 510282, China ; 4 Department of Respiratory Diseases, SUN Yat-sen Memorial Hospital, SUN Yat-sen University, Guangzhou 510120, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Chen
keywords: Inhaled corticosteroids (ICSs); leukotriene receptor antagonists (LTRAs); meta-analysis; theophylline