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. Epub 2017 Oct 9.

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.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Asthma / drug therapy*
  • Calcium Channel Blockers / therapeutic use*
  • Forced Expiratory Volume / drug effects*
  • Humans
  • Peak Expiratory Flow Rate / drug effects*
  • Placebos / administration & dosage
  • Vital Capacity / drug effects*

Substances

  • Calcium Channel Blockers
  • Placebos