Efficacy and safety of antagonists for chemoattractant receptor-homologous molecule expressed on Th2 cells in adult patients with asthma: a meta-analysis and systematic review

• Published in: Respiratory research Vol. 19; no. 1; p. 217
• Main Authors: Yang, Jing, Luo, Jian, Yang, Ling, Yang, Dan, Wang, Dan, Liu, Bicui, Huang, Tingxuan, Wang, Xiaohu, Liang, Binmiao, Liu, Chuntao
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 09.11.2018; BioMed Central; BMC
• Subjects: Adverse events; Allergies; Analysis; Antagonists (Biochemistry); Anti-Asthmatic Agents - administration & dosage; Asthma; Asthma - drug therapy; Asthma - metabolism; Asthmatic persons; Bronchodilators; Clinical medicine; Clinical trials; Confidence intervals; Corticosteroids; CRTH2 antagonist; Cytokines; Health aspects; Helper cells; Homology; Humans; Inflammation; Lung function; Lungs; Lymphocytes T; Medical research; Meta-analysis; Quality of life; Questionnaires; Randomized Controlled Trials as Topic - methods; Receptors, Immunologic - antagonists & inhibitors; Receptors, Immunologic - biosynthesis; Receptors, Prostaglandin - antagonists & inhibitors; Receptors, Prostaglandin - biosynthesis; Respiratory function; Review; Safety and security measures; Studies; Systematic review; Th2 Cells - drug effects; Th2 Cells - metabolism; Treatment Outcome; Systematic review; Lung function; Adverse events; CRTH2 antagonist; Asthma; Meta-analysis
• ISSN: 1465-993X; 1465-9921; 1465-993X; 1465-9921
• DOI: 10.1186/s12931-018-0912-y

Chemoattractant receptor-homologous molecule expressed on Th2 cells (CRTH2) antagonists are novel agents for asthma but with controversial efficacies in clinical trials. Therefore, we conducted a meta-analysis to determine the roles of CRTH2 antagonists in asthma. We searched in major databases for RCTs comparing CRTH2 antagonists with placebo in asthma. Fixed- or random-effects model was performed to calculate mean differences (MD), risk ratio (RR) or risk difference (RD) and 95% confidence interval (CI). A total of 14 trails with 4671 participants were included in our final analysis. Instead of add-on treatment of CRTH2 antagonists to corticosteroids, CRTH2 antagonist monotherapy significantly improved pre-bronchodilator FEV (MD = 0.09, 95% CI 0.04 to 0.15, P = 0.0005), FEV % predicted (MD = 3.65, 95% CI 1.15 to 6.14, P = 0.004), and AQLQ (MD = 0.25, 95% CI 0.09 to 0.41, P = 0.002), and reduced asthma exacerbations (RR = 0.45, 95% CI 0.23 to 0.85, P = 0.01). Rescue use of SABA was significantly decreased in both CRTH2 antagonist monotherapy (MD = - 0.04, 95% CI -0.05 to - 0.03, P < 0.00001) and as add-on to corticosteroids (MD = - 0.78, 95% CI -1.47 to - 0.09, P = 0.03). Adverse events were similar between the intervention and placebo groups. CRTH2 antagonist monotherapy can safely improve lung function and quality of life, and reduce asthma exacerbations and SABA use in asthmatics.