[Leukotriene antagonists--do they have a value?]

Guidelines on the treatment of asthma emphasize the importance of long-term control of the disease. The leukotriene receptor antagonists are a new class of maintenance therapy for the treatment of chronic asthma. In Switzerland two of these receptor antagonists are available, zafirlukast (Accolate) and montelukast (Singulair). Compared with placebo leukotriene antagonists are active and improve mild-to moderate asthma in terms of improving lung function and symptoms and decreasing exacerbations. However compared to low dose inhaled steroids LTRA are less effective and more expensive. Inhaled steroids therefore remain the preferred and most cost-effective therapy for treating chronic asthma. Among patients requiring moderate to high doses of inhaled corticosteroids to maintain asthma control LTRA allow for reduction of the doses. The best response to LTRA show patients who have aspirin-sensitive asthma.