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KMID : 0606920110190030269
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Biomolecules & Therapeutics
2011 Volume.19 No. 3 p.269 ~ p.301
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Comparison of Leukotriene Receptor Antagonist and Theophylline in Addition to Inhaled Corticosteroid in Adult Asthma: A Meta-Analysis
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Fang Huijuan
Wang Jianmiao
Jin Di
Cao Yong
Xu Yongjian
Xiong Weining
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Abstract
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This meta-analysis was performed to evaluate the difference of the therapeutic effi cacy and adverse effects of leukotriene receptor antagonist and theophylline added to inhaled corticosteroids in adult asthma. Databases were searched for studies published through Nov, 2010. Randomized-controlled trials containing inhaled corticosteroids plus leukotriene receptor antagonist and inhaled corticosteroids plus sustained-release theophylline for asthma therapy were selected. For each report, data were extracted to the outcomes analyzed: mean change in morning peak expiratory fl ow, mean change in evening peak expiratory flow, mean change in morning forced expiratory volume in 1 sec, mean change in daily short bete2-agonist use, asthma exacerbation and adverse effects. Four assessable trials including 182 asthmatic patients were identified. Inhaled corticosteroids plus leukotriene receptor antagonist was superior to inhaled corticosteroids plus theophylline therapy in improving morning peak expiratory flow in asthmatics (mean difference 19.08 [95% confi dence interval 13.37-23.79] l/min, p<0.001) and morning forced expiratory volume in 1 sec in asthmatics (mean difference 0.09 [95% confi dence interval 0.03-0.14] liter, p=0.001). In evening peak expiratory fl ow, daily short bete2-agonist use, asthma exacerbation and adverse effects, there was no signifi cant difference between these two therapies (All p>0.05). Our meta-analysis showed that the combination of inhaled corticosteroids plus leukotriene receptor antagonist resulted in more improvement in both peak expiratory fl ow and forced expiratory volume in 1 sec in the morning than inhaled corticosteroids plus sustained-release theophylline in adult asthmatics. Further trials are necessary to evaluate the dominant effects of the former combination.
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KEYWORD
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Asthma, Meta-analysis, Leukotriene receptor antagonist, Theophylline, Inhaled corticosteroids
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