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Published on: April 13, 2010
Bronchoprotective effects of leukotriene receptor antagonists in asthma: a meta-analysis
Graeme P Currie1, Brian J Lipworth
1Asthma and Allergy Research Group, Department of Clinical Pharmacology and Therapeutics, Ninewells Hospital and Medical School, University of Dundee, Dundee, Scotland.
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 >or= 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 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).
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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