Efficacy of antileukotriene agents in asthma management.
OBJECTIVE
This article reviews information on the role of three antileukotrienes (anti-LTs), montelukast, zafirlukast, and zileuton, in the management of asthma. After reading this article, readers should have an understanding of the efficacy of anti-LTs in specific patient populations.


METHODS
Relevant and appropriately controlled clinical studies on the efficacy of anti-LTs were used. Only literature in the English language was reviewed.


METHODS
Material was taken from peer-reviewed journals and published abstracts.


RESULTS
The efficacy of anti-LTs has been established in numerous randomized, controlled, multicenter trials involving patients with mild-to-moderate disease. These agents reduce asthma symptoms, beta2-agonist use, and asthma exacerbations, in addition to improving pulmonary function. The anti-LTs are also effective when added to low-dose or high-dose corticosteroid regimens in symptomatic asthma patients. They have proven efficacy in patients with aspirin-sensitive asthma, and they appear able to reduce nasal congestion in asthma patients with concomitant upper airway symptoms. Some anti-LTs have been shown to be effective in pediatric asthma patients.


CONCLUSIONS
In reviewing available clinical results as well as real-world experience in managing asthma patients, the Antileukotriene Working Group concludes that anti-LTs may be used in patients with mild persistent asthma as well as in combination with other asthma medications at all levels of disease severity for long-term maintenance of asthma control.
Nathan
R A
RA
Asthma and Allergy Associates, Colorado Springs 80907, USA. drrnathan@aol.com
Kemp
J P
JP
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy*; D002986:Clinical Trials as Topic; D006801:Humans; D020024:Leukotriene Antagonists / Q000627:therapeutic use*
D000305:Adrenal Cortex Hormones; D018927:Anti-Asthmatic Agents; D020024:Leukotriene Antagonists