Leukotriene-receptor antagonists. Role in asthma management.
OBJECTIVE
To examine the role of leukotriene-receptor antagonists (LTRAs) in management of asthma.


METHODS
Most data were derived from randomized, double-blind, controlled trials.


RESULTS
Leukotrienes appear to have an important role in the pathophysiology of asthma, including airway inflammation. Leukotriene-receptor antagonists are effective in improving asthma control end points, such as allergen, ASA, and exercise challenge, in clinical models of asthma. In chronic asthma, LTRA administration reduces asthma symptoms and rescue beta 2-agonist use, changes that are paralleled by improvements in lung function. Both zafirlukast and montelukast decrease circulating levels of eosinophils and could have other useful anti-inflammatory properties. Administration of LTRAs allows doses of inhaled corticosteroids to be reduced. Currently available LTRAs are free of serious side effects and are available as oral formulations.


CONCLUSIONS
Leukotriene-receptor antagonists belong to a new class of asthma medication. While inhaled corticosteroids remain first-line therapy for managing chronic asthma, LTRAs should be considered for patients with ASA-sensitive asthma; as adjunct therapy when low to moderate doses of inhaled steroid alone provide incomplete control; or as adjunct therapy to allow reduction in doses of inhaled corticosteroids.
D'Urzo
A D
AD
Department of Family and Community Medicine University of Toronto.
Chapman
K R
KR
D000085:Acetates / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D001986:Bronchial Spasm / Q000188:drug therapy; D002908:Chronic Disease; D003521:Cyclopropanes; D004311:Double-Blind Method; D006801:Humans; D007211:Indoles; D020024:Leukotriene Antagonists / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D048448:Phenylcarbamates; D011804:Quinolines / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D012138:Respiratory Therapy; D013440:Sulfides; D013449:Sulfonamides; D013997:Time Factors; D014105:Tosyl Compounds / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use
D000085:Acetates; D000305:Adrenal Cortex Hormones; D018927:Anti-Asthmatic Agents; D003521:Cyclopropanes; D007211:Indoles; D020024:Leukotriene Antagonists; D048448:Phenylcarbamates; D011804:Quinolines; D013440:Sulfides; D013449:Sulfonamides; D014105:Tosyl Compounds; C093875:montelukast; C062735:zafirlukast