Efficacy and safety of montelukast combined with budesonide in the treatment of eosinophilic bronchitis: a meta-analysis

Objective To systematically assess the efficacy and safety of Montelukast (MONT) combined with budesonide (BUN) in the treatment of eosinophilic bronchitis (EB). Methods A systematic search was performed in databases included PubMed, Cochrane Library, EMBase, CNKI, VIP, CBM and Wan Fang from established to October, 2018, to find the clinical random controlled trials of MONT combined with BUN for EB.This study also used the assessment tools of the Cochrane collaboration to evaluate the quality of eligible literatures which have met the criterion, and used RevMan 5.3.5 software for data processing. Results A total of 1 024 patients from 13 studies were involved in this study.The results of the meta-analysis showed that the total effective rate of MONT combined with BUN group was higher (P<0.001), thepulmonary function was significantly improved (P<0.001), and the recurrence rate was lower than that of the BUN group (P<0.001), compared with the BUN group.The levels of sputum eosinophil (P=0.01), peripheral blood eosinophils (P<0.001), fractional exhaled nitric oxide (P<0.001) and serum interleukin-5 (P<0.001) were significantly reduced.There was no significant difference in adverse reaction rate (P=0.96). Conclusions The clinical efficacy about MONT combined with BUN treatment of EB is more obvious than that of use of BUN alone, and the incidence of adverse reactions is not be significantly increased.However, more high-quality, multi-center, large-scale randomized controlled trials are needed for further validation. Key words: Budesonide; Meta-analysis; Montelukast; Eosinophilic bronchitis