Graeme P Currie1, Brian J Lipworth. 1. Asthma and Allergy Research Group, Department of Clinical Pharmacology and Therapeutics, Ninewells Hospital and Medical School, University of Dundee, Dundee, Scotland.
Abstract
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.
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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Authors: Graeme P Currie; John J Lima; Jim E Sylvester; Daniel K C Lee; Wendy J R Cockburn; Brian J Lipworth Journal: Br J Clin Pharmacol Date: 2003-10 Impact factor: 4.335