Effect of suplatast tosilate on antileukotriene non-responders with mild-to-moderate persistent asthma.
BACKGROUND
Immunomodulatory therapy has been recently introduced for the management of asthma. Suplatast tosilate (ST), a new immune-modifying drug, is known to improve the airway function by inhibiting the release of Th-2 cytokines. However, its efficacy as a controller listed in the guideline, Global Initiative for Asthma 2005 has not been established. In this study we investigated the role of ST in leukotriene receptor antagonist (LTRA) non-responders with mild-to-moderate persistent asthma before initiating corticosteroids inhalation therapy.


METHODS
This was a prospective open-level clinical trial. LTRAs was given to 41 patients with asthma for 4 weeks and clinical efficacy was assessed using daily symptom scores. The 10 patients, aged 2.5-8.5 years, who failed to show clinical improvement, were defined as LTRA non-responders. After a 1-week washout period, the efficacy of ST was investigated and compared with LTRA non-responders for the following 4 weeks.


RESULTS
LTRA non-responders showed a significant improvement in the average symptom score, peak expiratory flow, use of rescue medication and the proportion of symptom-free days with ST therapy.


CONCLUSIONS
ST is a good choice for patients who have failed to respond to LTRAs. ST should therefore be added to the list of treatment options for such patients.
Wada
Mariko
M
Department of Pediatrics, Juntendo University School of Medicine, Tokyo, Japan. maro@juntendo.ac.jp
Nagata
Satoru
S
Kudo
Takahiro
T
Shimizu
Toshiaki
T
Yamashiro
Yuichiro
Y
D000284:Administration, Oral; D000293:Adolescent; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001190:Arylsulfonates / Q000008:administration & dosage / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage / Q000627:therapeutic use*; D007223:Infant; D020024:Leukotriene Antagonists / Q000627:therapeutic use; D008297:Male; D011446:Prospective Studies; D013452:Sulfonium Compounds / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
D018927:Anti-Asthmatic Agents; D001190:Arylsulfonates; D007155:Immunologic Factors; D020024:Leukotriene Antagonists; D013452:Sulfonium Compounds; C073028:suplatast tosilate