Calcium channel blockers for lung function improvement in asthma: A systematic review and meta-analysis

Chiu et al., 2017 | Ann Allergy Asthma Immunol | Meta Analysis

Citation

Chiu Kam Yu, Li Jian Guo, Lin Ying. Calcium channel blockers for lung function improvement in asthma: A systematic review and meta-analysis. Ann Allergy Asthma Immunol. 2017-Dec;119(6):518-523.e3. doi:10.1016/j.anai.2017.08.013

Abstract

BACKGROUND: For decades, calcium channel blockers (CCBs) have been believed to play a role in asthma treatment. However, the clinical efficacy of CCBs for lung function improvement in patients with asthma has not been qualitatively evaluated. OBJECTIVE: To assess the effect of CCBs vs placebo on lung function test results in adults with asthma. METHODS: Various databases were systematically searched to identify all randomized clinical trials with adults with asthma. We aimed to assess the influence of CCBs on forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), peak expiratory flow rate (PEFR), and provocative concentration of bronchoconstrictive agents causing a 20% decrease in FEV1 (PC20) compared with a placebo. All effect estimates were pooled by the generic inverse variance method with random-effects meta-analysis. Subgroup analysis, sensitivity analysis, and heterogeneity investigation were performed. RESULTS: Thirty eligible articles with 301 patients were included in this meta-analysis. Our results revealed that in a standard exercise test CCBs could produce a mean maximal percentage decrease in FEV1 of 11.56% (95% confidence interval, 8.97%-14.16%; P < .001) and an increase in postdose FEV1 by 80 mL (95% confidence interval, 0.02-0.15 mL; P = .01). However, there was no statistical significance for CCBs in postdose FVC, PEFR, or PC20 of histamine and methacholine. CONCLUSION: CCBs may be beneficial for lung function improvement in asthma, especially in exercise-induced asthma. However, there is a lack of evidence for CCBs protecting asthma patients from chemical irritation.

Key Findings

Thirty eligible articles with 301 patients were included in this meta-analysis. Our results revealed that in a standard exercise test CCBs could produce a mean maximal percentage decrease in FEV1 of 11.56% (95% confidence interval, 8.97%-14.16%; P < .001) and an increase in postdose FEV1 by 80 mL (95% confidence interval, 0.02-0.15 mL; P = .01). However, there was no statistical significance for CCBs in postdose FVC, PEFR, or PC20 of histamine and methacholine.

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population asthma has not been
Sample Size 301
Age Range See abstract
Condition See abstract

MeSH Terms

  • Asthma
  • Calcium Channel Blockers
  • Forced Expiratory Volume
  • Humans
  • Peak Expiratory Flow Rate
  • Placebos
  • Vital Capacity

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Systematic Review
  • Vertical: calcium

Provenance


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