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The Effectiveness of Anti-leukotriene Agents in Patients with COPD: A Systemic Review and Meta-analysis

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Abstract

Background

Anti-leukotriene (anti-LT) agents have been not yet established for effectiveness in patients with chronic obstructive pulmonary disease (COPD). We performed a systematic review and meta-analysis to assess whether anti-LT agents have the responsiveness for COPD patients.

Methods

MEDLINE, EMBASE, Cochrane Central Register, and Korea Med were searched for relevant clinical trials to review.

Results

Seven studies involving 342 patients were finally analyzed. Pooled estimation from three randomized controlled studies did not demonstrate that anti-LT agents increased forced expiratory volume in 1 s [overall effect: 0.09 L, 95 % confidence interval (CI) −0.04 to 0.21; P = 0.17; I 2 = 41.0 %] or forced vital capacity (overall effect: 0.04 L, 95 % CI −0.04 to 0.11; P = 0.64; I 2 = 0.0 %). As for inflammatory markers, anti-LT agents did not affect the level of myeloperoxidase (standardized mean difference, −0.15; 95 % CI −0.65 to 0.36) or LTB4 (standardized mean difference, −0.41; 95 % CI −0.96 to 0.13). They reduced the frequency of dyspnea [relative risk (RR) 0.43; 95 % CI 0.29 to 0.64] and sputum (RR 0.37; 95 % CI 0.22 to 0.63), based on overall estimation from two non-randomized studies. However, our review revealed that there are few well-designed, randomized controlled studies with large sample sizes and long treatment durations.

Conclusion

Although symptomatic improvements were demonstrated in some studies, there is a lack of evidence to support the therapeutic efficacy of anti-LT agents in patients with COPD. Further large-scale, long-term studies are needed to identify predictive factors for COPD patients who may benefit from anti-LT agents.

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Acknowledgments

This work was supported by the research grant from Jeju National University Hospital. Jong Hoo Lee and Yee Hyung Kim planned this study, reviewed trials, collected and analyzed data. Jong Hoo Lee made the first draft of the manuscript. Yee Hyung Kim and Hyun Jung Kim revised the manuscript.

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Internal Medicine, School of Medicine, Jeju National University Hospital, Jeju National University, Jeju City, Korea

    Jong Hoo Lee

  2. Department of Preventive Medicine, Institute for Evidence-based Medicine, College of Medicine, Korea University, Seoul, Korea

    Hyun Jung Kim

  3. Department of Pulmonary and Critical Care Medicine, Kyung Hee University Hospital at Gangdong, School of Medicine, Kyung Hee University, 892, Dongnamro, Gangdonggu, Seoul, 134-727, Republic of Korea

    Yee Hyung Kim

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  1. Jong Hoo Lee
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Correspondence to Yee Hyung Kim.

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Lee, J.H., Kim, H.J. & Kim, Y.H. The Effectiveness of Anti-leukotriene Agents in Patients with COPD: A Systemic Review and Meta-analysis. Lung 193, 477–486 (2015). https://doi.org/10.1007/s00408-015-9743-5

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