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Montelukast for Postinfectious Cough: A Systematic Review of Randomized Controlled Trials
1Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, West China Medical School, Sichuan University, Chengdu 610041, China, Chengdu 610041, China.
Objectives:
To systematically assess the efficacy and safety of montelukast for postinfectious cough (PIC) and to propose a recommendation via a systematic review of all available randomized controlled trials (RCTs).
Methods:
Electronic databases and relevant journals were searched for RCTs from inception to July 2014. In addition, some unpublished literature was also searched. All studies included in the systematic review met the same inclusion criteria. Methodological quality and evidence quality were examined according to Cochrane handbook. The data were extracted and trial quality was assessed independently by two reviewers.
Results:
Fourteen RCTs involving 1372 patients were included in our review. The methodological quality of the included trials was poor because one or more biases were observed in these studies. The quality of evidence was low to moderate levels. All trials reported better effect favouring montelukast treatment. Findings suggested that compared with other Western medication and Chinese medicine, montelukast showed significant effects in shortening cough relief time, increasing the clinic obvious effective rate, decreasing coughing frequency and severity, and improving quality of life. Adverse events were mentioned in six studies, but no serious adverse effects were reported in any of them.
Conclusions:
Montelukast demonstrated potential positive efficacy and safety for PIC; however, we could not come to a firm conclusion on the efficacy and safety of montelukast for PIC. More high quality randomized controlled trials are required to confirm the efficacy and safety of montelukast for PIC.
Insights
Montelukast shows promise for treating postinfectious cough (PIC), improving symptoms and quality of life. However, more high-quality studies are needed to confirm its effectiveness and safety for PIC.
Area of Science:
- Respiratory Medicine
- Pharmacology
Background:
- Postinfectious cough (PIC) is a common condition with limited treatment options.
- Assessing the efficacy of pharmacological interventions is crucial for improving patient outcomes.
Purpose of the Study:
- To systematically review randomized controlled trials (RCTs) evaluating montelukast for PIC.
- To assess the efficacy and safety of montelukast in managing postinfectious cough.
Main Methods:
- A comprehensive search of electronic databases and journals was conducted for RCTs.
- Methodological quality and evidence quality were assessed using the Cochrane handbook.
- Data extraction and quality assessment were performed independently by two reviewers.
Main Results:
- Fourteen RCTs with 1372 patients were included; however, methodological quality was generally poor.
- Montelukast demonstrated significant benefits in shortening cough relief time, reducing frequency and severity, and improving quality of life compared to other treatments.
- While adverse events were reported, no serious side effects were noted.
Conclusions:
- Montelukast shows potential efficacy and safety for postinfectious cough.
- The current evidence quality is low to moderate, precluding firm conclusions.
- Further high-quality randomized controlled trials are necessary to definitively establish montelukast's role in PIC management.