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Clinical Investigations: ASTHMA |

Bronchoprotective Effects of Leukotriene Receptor Antagonists in Asthma*: A Meta-analysis

Graeme P. Currie, MBChB; Brian J. Lipworth, MD
Author and Funding Information

*From the Asthma and Allergy Research Group, Department of Clinical Pharmacology and Therapeutics, Ninewells Hospital and Medical School, University of Dundee, Dundee, Scotland.

Correspondence to: Brian J Lipworth, MD, Professor of Allergy and Pulmonology, Department of Clinical Pharmacology and Therapeutics, Ninewells Hospital and Medical School, University of Dundee, Dundee DD1 9SY, Scotland; e-mail: b.j.lipworth@dundee.ac.uk



Chest. 2002;122(1):146-150. doi:10.1378/chest.122.1.146
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Study 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).

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

Setting: MEDLINE, BIDS, and Cochrane Library data registers.

Measurements: The doubling dose/dilution difference that caused a 20% fall in the FEV1 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).

Conclusion: Since the estimated protection amounted to almost one doubling dose, this reinforces the role of LTRAs as anti-inflammatory therapy in asthma.

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