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Zafirlukast (Accolate).

K F Chung1, P J Barnes

  • 1Thoracic Medicine, National Heart & Lung Institute, Imperial College School of Medicine, London, UK.

Drugs of Today (Barcelona, Spain : 1998)
|March 11, 2004
PubMed
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Zafirlukast, a leukotriene receptor antagonist, improves asthma control and lung function in mild to moderate cases. While generally well-tolerated, higher doses may affect liver enzymes, and its efficacy is less than inhaled steroids for some measures.

Area of Science:

  • Pharmacology
  • Respiratory Medicine
  • Allergy and Immunology

Background:

  • Cysteinyl-leukotrienes are key mediators in asthma pathogenesis.
  • Zafirlukast is a selective leukotriene receptor antagonist for asthma treatment.

Purpose of the Study:

  • To evaluate the efficacy and safety of zafirlukast in managing asthma.
  • To compare zafirlukast with other asthma therapies, including inhaled corticosteroids and sodium cromoglycate.

Main Methods:

  • Review of published data and presented studies on zafirlukast efficacy.
  • Meta-analysis of five large studies assessing asthma exacerbations.
  • Assessment of lung function (FEV(1), peak expiratory flow) and symptom control.

Main Results:

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  • Zafirlukast (20 mg twice daily) improved lung function and symptom control, reducing short-acting beta-agonist use in mild to moderate asthma.
  • Efficacy was comparable to sodium cromoglycate but less than inhaled beclomethasone dipropionate.
  • Adding zafirlukast (80 mg twice daily) improved outcomes in symptomatic patients on high-dose inhaled steroids.
  • Meta-analysis showed a significant reduction in asthma exacerbations versus placebo.
  • Zafirlukast (20 mg twice daily) was well-tolerated; higher doses (80 mg twice daily) were linked to elevated liver enzymes.

Conclusions:

  • Zafirlukast is a valuable oral option for asthma management, particularly for patients with compliance issues with inhaled therapies.
  • It can be used alongside inhaled or oral corticosteroids.
  • Further research is needed to define its role as a first-line anti-inflammatory agent in mild asthma.