Evidence map›Paper›PMID 34273977›Full record

SynthesisRespiratory research2021

Antileukotrienes for the prevention and treatment of chronic lung disease in very preterm newborns: a systematic review.

Marlide Jukema, Franciszek Borys, Greta Sibrecht, Karsten Juhl Jørgensen, Matteo Bruschettini

Open access · goldAbstract readSystematic Review
In one paragraph

Synthesis in Respiratory research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
0.7field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Treatment of bronchial asthma - A simplified overview.Lung India : official organ of Indian Chest Society · 2026
    Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 4 institutions in 4 countries.

Marlide JukemaAmsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Franciszek BorysPoznan University of Medical Sciences, Poznan, Poland.
Greta SibrechtDepartment of Newborns Infectious Diseases, Poznan University of Medical Sciences, Poznan, Poland.
Karsten Juhl JørgensenThe Nordic Cochrane Centre, Rigshospitalet Dept., 7811, Blegdamsvej 9, 2100, Copenhagen, Denmark.
Matteo BruschettiniCochrane Sweden, Dept. Research and Development, Skåne University Hospital, Clinical Science Lund, Lund University, Lund, Sweden. matteo.bruschettini@med.lu.se.ORCID http://orcid.org/0000-0002-4775-872X
Poznan University of Medical Sciences · PLAmsterdam University Medical Centers · NLLund University · SERigshospitalet · DK

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundVery preterm infants are at high risk of developing chronic lung disease, which requires respiratory support and might have long-term sequelae. As lung inflammation plays an important role in pathogenesis, antileukotrienes have been explored in both clinical and animal studies. We aimed to assess the benefits and harms of antileukotrienes for the prevention and treatment of respiratory morbidity and mortality in very preterm newborns.

methodsIn this systematic review, we included randomized trials and non-randomized studies in humans and animals reporting the effects of antileukotrienes in very preterm infants or other mammals within 10 days of birth. Our pre-specified primary outcomes were all-cause mortality and any harm, and, for the clinical studies, incidence of chronic lung disease. Included studies underwent risk of bias-assessment and data extraction performed by two authors independently. There were no language restrictions.

resultsFifteen studies totally met our inclusion criteria: one randomized trial and four non-randomized studies in humans and 10 animal studies (five in rodents, two in lambs and one in either guinea pigs, rabbits or caprinae). All five clinical studies used montelukast and had a small sample size, ranging from 4 to 77 infants. The randomized trial (n = 60) found no difference in the incidence of chronic lung disease between the groups. Only one clinical study, which enrolled four very preterm infants and had a critical overall risk of bias, reported long-term outcomes. All other studies had unclear or greater overall risk of bias and meta-analyses were therefore deemed unfeasible. Eight of ten animal studies used leukotriene receptor antagonists as antileukotriene (montelukast in three of ten studies) and seven had an experimental study design (i.e. some animals were not exposed to antileukotrienes but no randomization). Three of the ten animal studies assessed different doses. Animal studies found no effect on the outcomes mortality, growth, or lung function related surrogate outcomes.

conclusionsUse of antileukotrienes in very preterm infants to prevent or treat chronic lung disease is not supported by the available evidence. Large randomized trials focusing on outcomes relevant to patients, including long-term outcomes, are needed. Studies should also minimize risk of bias.

Indexed as

Disease Models, AnimalAnimalsAnimals, NewbornChronic DiseaseHumansInfant, Extremely PrematureInfant, NewbornInfant, Premature, DiseasesLeukotriene AntagonistsLung DiseasesRandomized Controlled Trials as TopicLeukotriene AntagonistsAnimal modelChronic lung diseasePreterm infantsRespiratory morbiditySYRCLE

Identifiers

PMID34273977
PMCPMC8286041
OpenAlexW3183741896

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.