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Anti-leukotrienes: here to stay?
1Department of Thoracic Medicine, National Heart and Lung Institute, Dovehouse Street, London SW3 6LY, UK. p.j.barnes@ic.ac.uk
Current Opinion in Pharmacology
|June 18, 2003
Summary
Anti-leukotrienes offer a new approach to asthma treatment by blocking cysteinyl-leukotriene-1 receptors. However, they are less effective than inhaled corticosteroids and other therapies, limiting their clinical utility.
Area of Science:
- Pharmacology
- Respiratory Medicine
- Immunology
Background:
- Cysteinyl-leukotrienes play a significant role in asthma pathophysiology.
- Increased levels and tissue responsiveness to cysteinyl-leukotrienes are observed in asthma patients.
- Anti-leukotrienes represent a novel class of anti-asthmatic medications targeting these mediators.
Purpose of the Study:
- To evaluate the efficacy and clinical utility of anti-leukotrienes in asthma management.
- To compare anti-leukotrienes with existing asthma therapies, including inhaled corticosteroids and long-acting beta(2)-receptor agonists.
- To assess the cost-effectiveness and future prospects of anti-leukotriene therapy.
Main Methods:
- Review of scientific rationale for anti-leukotriene use.
- Analysis of clinical trial data comparing anti-leukotrienes to placebo, inhaled corticosteroids, and long-acting beta(2)-receptor agonists.
- Evaluation of clinical practice utility and cost-effectiveness.
Main Results:
- Anti-leukotrienes demonstrate benefit over placebo in clinical trials.
- They are less effective than low-dose inhaled corticosteroids and long-acting beta(2)-receptor agonists.
- Clinical practice has shown limited utility and cost-effectiveness compared to other treatments.
Conclusions:
- Anti-leukotrienes are a weak second-line therapy for asthma.
- Significant future improvements in this drug class are unlikely.
- Current evidence suggests limited value in clinical practice beyond specific indications.