Related Experiment Videos
Leukotriene receptor antagonists in the treatment of asthma
1School of Pharmacy, University of Wisconsin-Madison, 53706, USA.
Abstract:
The role of leukotriene receptor antagonists in the treatment of persistent asthma is in evolution. Pivotal 8-12-week, randomized, controlled trials in both adults and children have shown efficacy, as defined by standard asthma outcomes. Tolerance to therapy did not develop, nor did rebound worsening of asthma symptoms once therapy was withdrawn. In a comparator trial of montelukast versus beclomethasone, the average percentage change from baseline in forced expiratory volume in 1 second was greater with the inhaled corticosteroid preparation; however, improvements in other asthma outcomes were similar. There was considerable heterogeneity of pulmonary response with both treatments, with good and poor responders in both groups. In an open-label, crossover comparison of montelukast versus cromolyn, both parents and children preferred montelukast, thus regimen adherence was greater with montelukast. Additional long-term, randomized, controlled trials will define the effectiveness of leukotriene receptor antagonists compared with established controllers, thus determining the leukotriene receptor antagonists' place in asthma management.
Insights
Leukotriene receptor antagonists demonstrate efficacy in treating persistent asthma without tolerance issues. While inhaled corticosteroids show greater lung function improvement, these antagonists offer comparable symptom relief and better adherence.
Area of Science:
- Pulmonology
- Pharmacology
Background:
- Persistent asthma treatment is evolving.
- Leukotriene receptor antagonists (LTRAs) are a class of asthma medications.
Purpose of the Study:
- To review the efficacy and role of LTRAs in persistent asthma management.
- To compare LTRAs with other asthma treatments.
Main Methods:
- Review of pivotal randomized controlled trials (RCTs) in adults and children.
- Comparison trials including montelukast vs. beclomethasone and montelukast vs. cromolyn.
Main Results:
- RCTs show LTRA efficacy in standard asthma outcomes; no tolerance or rebound worsening observed.
- Montelukast showed similar asthma outcome improvements compared to beclomethasone, despite lower FEV1 changes.
- Montelukast demonstrated superior adherence over cromolyn in a patient preference trial.
Conclusions:
- LTRAs are effective for persistent asthma, with good adherence.
- Further long-term RCTs are needed to establish LTRAs' definitive role in asthma management compared to existing controllers.