And objective Background The purpose of asthma management is to achieve a total asthma control that involves current control and future risk. (OR?=?0.72, 95% CI?=?[0.18, 2.99]). Intriguingly, there was not a significant difference in asthma exacerbations between zafirlukast and ICs (OR?=?1.12, 95% CI?=?[0.53, 2.34]). Conclusions Our study suggests that zafirlukast, as the first-line therapy, significantly reduces mild to moderate but not severe asthma exacerbations. In the add-on regimen, zafirlukast could not reduce asthma exacerbations, which would perhaps result from small sample size and needs to be further buy NVP-BHG712 researched. Keywords: Asthma exacerbations, First-line and add-on therapy, Meta-analysis, Organized review, Zafirlukast Launch Asthma is really a chronic inflammatory disorder of airways connected with airway hyperresponsiveness closely. It’s estimated that around 300 million people have problems with asthma and the responsibility of the disease to government authorities, healthcare systems, households, and sufferers can be increasing globally [1,2]. Despite advancements in understanding of the pathophysiology of availability and asthma of effective therapy, asthma can’t be cured however currently. The purpose of asthma treatment can be to attain and keep maintaining asthma optimum control, which include current control and long-term elements known as risk or upcoming risk since 2009 [3]. Asthma control can be evaluated by a worldwide evaluation of asthma symptoms, reliever medication make Rabbit Polyclonal to KCNK15 use of, lung function, as well as the regularity/intensity of exacerbations. It really is disappointing that just 2% of asthma sufferers are considered managed across eight Asia-Pacific countries and Hong Kong in real life configurations when control can be assessed utilizing the Global Effort for Asthma (GINA) classification [4]. Asthma exacerbations, as the utmost important upcoming risk, are named a common scientific manifestation in sufferers with serious asthma, and so are known to increase the risk of asthma mortality [5]. Hence, in recent years to prevent asthma exacerbations has been identified as an important component of establishing ideal asthma control in all asthma treatment guidelines. Inhaled corticosteroids (ICs) and combination of ICs/long-acting 2-agonists (LABA) are the mainstay of therapy for reducing asthma exacerbations including the severe ones, but some patients require additional treatment or prefer not to use ICs. In such patients, leukotriene receptor antagonist (LTRA), is a promising alternative to ICs therapy. Although LTRA has been proven to be effective in improving asthma control in clinical practice, few studies systematically focused on effects of LTRA on future asthma outcomes, such as exacerbations and their various types. Furthermore, the relative effect size of LTRAs for prevention buy NVP-BHG712 of future risk of buy NVP-BHG712 asthma exacerbations remains unclear. Also because there is a great heterogeneity in pooled data of different types of LTRA, such as montelukast, zafirlukast, panlukastandzileuton [6]. This systematic review and meta-analysis is usually aimed to explore effects of zafirlukast, as first-line and add-on therapy, on prevention of asthma exacerbations in adults. Methods Search strategy and selection criteria We searched electronic databases including PubMed (1991 to June 2013), Embase (1992 to June 2013) and Web of Science (1992 to June 2013) for randomized controlled trials (RCTs) using a comprehensive search strategy including the following keywords: zafirlukast AND (asthma or wheezing), Limits Activated: Randomized Controlled Trial (RCT). We reviewed reference lists of all included studies, systematic reviews and narrative reviews to identify potentially relevant citations. There was no limitation on language or 12 months of publication. Trials were included if they met the following criteria: they were randomized controlled trials comparing zafirlukast versus placebo or other active drugs and reporting at least one asthma exacerbation. The trials were excluded if the patients were hospitalized for acute asthma because the main outcome of this study for zafirlukast in treating asthma included hospitalization for asthma exacerbation. After exclusion of duplicates, two reviewers (C.F.C. and Y.L.) reviewed the full text of most citations with game titles and abstracts that appeared to suit the requirements of addition. Irrelevant buy NVP-BHG712 citations or not really randomized managed trials weren’t reviewed completely text. The real variety of citations rejected and the reason why for rejection were tracked. Data quality and removal evaluation We evaluated each entitled citation, and obtained the entire text of most definite of feasible randomized managed trials. From each article we extracted details regarding authors, 12 months of publication, sex, sample size, sample size calculation, standard treatments, interventions buy NVP-BHG712 as the first-line or add-on therapies, outcomes, adverse events, and intention to treat analysis and so.