PURPOSE:Chronic obstructive pulmonary disease(COPD) is one of the most common diseases causing substantial lifestyle impairment. With the current treatment regimens, many patients continue to have significant symptoms. Leukotriene antagonists traditionally used in allergy and asthma therapy may offer additional benefit to COPD patients.
METHODS:A literature search through MEDLINE, EMBASE and Cochrane databases was performed identifying four placebo-controlled trials of leukotriene antagonists. A total of 185 patients with confirmed COPD received measurements of FEV1 pre- and post-treatment with a leukotriene antagonist. 156 patients also had measurements of FVC. A meta-analysis using random-effects model was performed on the results of the four studies.
RESULTS:All of the students showed a significant change in FEV1 with leukotriene antagonist usage compared to placebo. Patients experienced a mean increase of 0.0987L (95% CI, 0.0097 to 0.1876) in FEV1. The maximal effect occurred between 2–3 hours post-treatment. FVC also showed a mean increase of 0.0977L (95% CI, 0.034 to 0.1614).
CONCLUSION:COPD patients using leukotriene antagonists showed a significant improvement in FEV1. FVC showed a smaller, but still significant improvement.
CLINICAL IMPLICATIONS:Leukotriene antagonists provide an alternative treatment for COPD. The effect may be dependent on many clinical variables. The activity of leukotriene antagonists in COPD reinforces the concept that there is a component of mast cell-induced airway reactivity in COPD.
DISCLOSURE:Minh Nguyen, None.