Antileukotrienes in the treatment of asthma and allergic rhinitis.
OBJECTIVE
To compare leukotriene antagonists (LTA) to other groups of drugs used in asthma and allergic rhinitis treatment.


METHODS
MEDLINE, LILACS and Cochrane Library.


BACKGROUND
leukotrienes, antileukotrienes, asthma treatment, allergic rhinitis treatment, asthma and allergic rhinitis. An attempt was made to group the main studies and reviews about this topic.


RESULTS
LTA are more efficient than placebo and enhance the effects of inhaled corticosteroids. The association of inhaled corticosteroids with long-acting Beta2 agonists is more efficient than the association of inhaled corticosteroids + LTA. Although use of LTA in acute asthma attacks and allergic rhinitis seems reasonable, more studies are needed to confirm this benefit. LTA reduce hospitalization time and the number of wheezing attacks in infants with acute viral bronchiolitis caused by respiratory syncytial virus, as well as recurrent wheezing after acute viral bronchiolitis. LTA are less efficient than intranasal corticosteroids for allergic rhinitis management. LTA are efficient in exercise-induced asthma, although they are not the first-line treatment.


CONCLUSIONS
Controlled and randomized studies show that inhaled corticosteroids are the drugs of choice to treat persistent asthma and allergic rhinitis. There is not enough evidence to recommend the use of LTA as first-line drug (monotherapy) in children with asthma (level I). For children who cannot use inhaled corticosteroids, LTA may be a good alternative (level II).
Ribeiro
Jose Dirceu
JD
Setor de Pneumologia Pediátria, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil. dirceus@ajato.com.br
Toro
Adyléia A D C
AA
Baracat
Emilio C E
EC
D000208:Acute Disease; D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000318:Adrenergic beta-Agonists / Q000627:therapeutic use*; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy*; D001250:Asthma, Exercise-Induced / Q000188:drug therapy; D002648:Child; D004359:Drug Therapy, Combination; D006801:Humans; D007223:Infant; D020024:Leukotriene Antagonists / Q000627:therapeutic use*; D015289:Leukotrienes / Q000145:classification / Q000378:metabolism; D008565:Membrane Proteins / Q000378:metabolism; D018077:Receptors, Leukotriene / Q000378:metabolism; D012137:Respiratory System / Q000187:drug effects; D012220:Rhinitis / Q000188:drug therapy*; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D000318:Adrenergic beta-Agonists; D018927:Anti-Asthmatic Agents; D020024:Leukotriene Antagonists; D015289:Leukotrienes; D008565:Membrane Proteins; D018077:Receptors, Leukotriene; C083169:leukotriene D4 receptor