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Pharmacotherapy of asthma in children, with special reference to leukotriene receptor antagonists
1Department of Medicine, University of Minnesota, Minneapolis, MN, USA. SCWEISMD@AOL.COM
Insights
New antileukotriene drugs offer improved asthma management for children and young adults. These therapies target airway inflammation, showing promise in clinical trials for better pulmonary function and symptom control.
Area of Science:
- Pulmonology
- Pediatric Allergy and Immunology
- Pharmacology
Background:
- Asthma is a chronic inflammatory airway disease, with increasing prevalence and mortality in the US.
- Current asthma treatments have limitations, necessitating safer and more effective anti-inflammatory options, especially for pediatric populations.
- Leukotrienes are key lipid mediators implicated in asthma pathogenesis and symptomology.
Purpose of the Study:
- To evaluate the efficacy and tolerability of antileukotriene agents in managing asthma.
- To explore the potential of these drugs in addressing the limitations of existing asthma therapies.
- To assess the suitability of antileukotriene drugs for pediatric asthma patients.
Main Methods:
- Clinical trials were conducted to assess the impact of antileukotriene drugs on asthma.
- Data on pulmonary function, symptom reduction, and use of concomitant asthma medications were collected.
- Patient compliance and tolerability of orally bioavailable antileukotriene agents were evaluated.
Main Results:
- Antileukotriene drugs, including zafirlukast, montelukast, and zileuton, demonstrated improvements in pulmonary function in adult asthma patients.
- These agents effectively decreased asthma symptoms and reduced the need for other asthma medications.
- Orally administered antileukotriene agents were generally well-tolerated, suggesting potential for enhanced patient compliance.
Conclusions:
- Antileukotriene therapy represents a promising approach for managing asthma, particularly in children and young adults.
- Montelukast and zafirlukast are approved for pediatric asthma, with zafirlukast pending approval, highlighting their established safety and efficacy.
- These drugs offer a well-tolerated, orally available option to target the inflammatory pathways in asthma.
Abstract:
Asthma in adults is generally recognized as a chronic inflammatory airway disease, although this association is less well established in childhood asthma. Thus, recent asthma guidelines have emphasized that asthma treatment should be directed toward the underlying inflammatory aspects of the disease. The prevalence of asthma and resultant hospitalizations and deaths have increased or remained stable over the past 10 years in the United States. In part, this appears to be caused by shortcomings of available antiasthma therapeutic agents. Because these trends are particularly troublesome in children and young adults, there is a need for effective anti-inflammatory therapies that are safe and tolerable. The leukotrienes are a family of lipid mediators that appear to play an important role in the symptomology and pathogenesis of asthma. The results of clinical trials in adults with asthma demonstrated that antileukotriene drugs such as zafirlukast, montelukast, and zileuton improve pulmonary function, decrease asthma symptoms, and decrease the concomitant use of other antiasthma drugs. Most antileukotriene agents are orally bioavailable and well tolerated, offering the potential for improved patient compliance. Montelukast and zafirlukast have received approval for use in pediatric asthma patients, and approval of zafirlukast in this patient population is pending.