Montelukast For Chronic Obstructive Pulmonary Disease:a Systematic Review

Objective To investigate efficacy and safety of Montelukast for patients with Chronic Obstructive Pulmonary Disease.Methods Databases including The Cochrane Library, PubMed, EMbase, WanFang Data and CNKI were searched electrically to collect trials (RCTs) about Montelukast for chronic obstructive pulmonary disease published from the date of their establishment to2012and relevant periodicals and references of the included studies were also manually retrieved. According to the inclusion and exclusion criteria, related cohort studies were selected, data were extracted, and quality of the included studies was evaluated by two reviewers independently,and meta-analysis was conducted by using RevMan5.0software.Results A total of875patients involving14RCTs were included finally.The results of meta-analysis showed that:montelukast in improving COPD patients FEV1[MD=0.78,95%CI (0.37,1.19), P=0.0002],FVC[MD=0.27,95%Cl (0.15,0.39), P<0.00001], FEVI/FVC[MD=0.27,95%CI (0.15,0.39), P<0.0002],FEV1%pred[MD=10.25,95%CI (6.20,14.30), P<0.00001] was superior than the control group, there were no significant differences in PEF[MD=2.14,95%Cl (-0.50,4.78), P=0.11]; montelukast can improve blood gas analysis in PO2[MD=0.73,95%CI (0.22,1.24), P=0.005], PCO2[MD=0.44,95%CI (0.25,0.63), P O.00001],and montelukast shorten the symptom remission time than the control group[WMD=0.27,95%CI (0.15,0.39), P <0.00001]; while in side reaction headache was more common, in addition to occasional nausea, upper abdominal discomfort, flu-like symptoms, but can relieve itself.Conclusion Montelukast can significantly improve the lung function of COPD patients, including FEVI, FEV1%pred, FVC, FEV1/FVC, but there is no significant difference in the PEF.Due to the limitation of quantity and quality of the included studies, the safety of Montelukast has to be further proved by conducting more high quality, large scale and multicenter RCTs.