title: Novel therapies in asthma:  leukotriene antagonists, biologic agents, and beyond.
abstract: Asthma is one of the most common conditions seen in clinical practice and carries both a significant disease burden in terms of patient morbidity and a high economic burden in both direct and indirect costs. Despite this, it remains a comparatively poorly understood disease, with only modest advances in treatment over the past decade. Corticosteroids remain the cornerstone of therapy. Both patient compliance with medications and physician adherence to evidence-based guidelines are often poor, and a high percentage of patients continue to have inadequately controlled disease even with optimal therapy. Following a contextual overview of the current treatment guidelines, this review focuses on novel asthma therapies, beginning with the introduction of the leukotriene receptor antagonist zafirlukast in the 1990s, continuing through advanced endoscopic therapy and into cytokine-directed biologic agents currently in development. Along with clinically relevant biochemistry and pharmacology, the evidence supporting the place of these therapies in current guidelines will be highlighted along with data comparing these agents with more conventional treatment. A brief discussion of other drugs, such as those developed for unrelated conditions and subsequently examined as potential asthma therapies, is included.
authors.affiliation: Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, University of Florida, Gainesville, FL 32610-0225, USA. papiee@medicine.ufl.edu
authors.forename: Eric S
authors.initials: ES
authors.lastname: Papierniak
authors.forename: David T
authors.initials: DT
authors.lastname: Lowenthal
authors.forename: Eloise
authors.initials: E
authors.lastname: Harman
mesh_terms: D055011:Ablation Techniques / Q000009:adverse effects / Q000379:methods; D000465:Algorithms; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D000888:Antibodies, Anti-Idiotypic / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D001249:Asthma / Q000145:classification / Q000188:drug therapy* / Q000601:surgery; D001999:Bronchoscopy; D003661:Decision Support Techniques; D017277:Drug Approval; D006801:Humans; D020024:Leukotriene Antagonists / Q000627:therapeutic use; D000069444:Omalizumab; D017410:Practice Guidelines as Topic; D014481:United States
chemical_list: D018927:Anti-Asthmatic Agents; D000888:Antibodies, Anti-Idiotypic; D061067:Antibodies, Monoclonal, Humanized; D020024:Leukotriene Antagonists; D000069444:Omalizumab