Leukotriene receptor antagonists do not improve lung function decline in COPD: a meta-analysis.

Abstract

Leukotriene receptor antagonists (LTRA), the anti-inflammatory agents, have been reported new therapeutic value in chronic obstructive pulmonary disease (COPD). However, the effects of LTRA on lung function decline in COPD were determined with inconsistent results and a meta-analysis is needed. Published cohort or randomized controlled studies were retrieved from PubMed and Embase databases. Pooled standardized mean difference (SMD) with 95% confidence interval (CI) was calculated in a random effects model. Six studies involving 221 COPD patients were included. Pooled effect size showed no significant improvements in FEV1 (SMD: 0.28, 95% CI: -0.17 to 0.72, p=0.227), FVC (SMD: 0.54, 95% CI: -0.10 to 1.18, p=0.597) and FEV1/FVC (SMD: 0.18, 95% CI: -0.09 to 0.46, p=0.189) in COPD patients after LTRA treatment. In subgroup analysis, neither short-term (<1 year) (SMD: 0.47, 95% CI: -0.06 to 0.99, p=0.082) nor long-term (≥1 year) (SMD: -0.13, 95% CI: -0.57 to 0.31, p=0.561) LTRA exposure could benefit lung function decline in COPD. This meta-analysis suggests neither short-term nor long-term exposure of LTRA can improve lung function decline in COPD. However, large scale randomized controlled trials are urgently warranted.