Leukotriene receptor antagonists for eczema

Area of Science:

• Dermatology
• Pharmacology
• Clinical Trials

Background:

• Eczema is a chronic inflammatory skin condition often linked to asthma.
• Current eczema treatments have limitations in tolerability and side effects.
• Leukotriene receptor antagonists (LTRAs) are used for asthma but their role in eczema is debated.

Purpose of the Study:

• To evaluate the efficacy and safety of leukotriene receptor antagonists (LTRAs) for treating eczema.
• To assess the benefits and harms of LTRAs as a potential alternative or adjunctive therapy for eczema.

Main Methods:

• Systematic review of randomized controlled trials (RCTs) identified through extensive database searches up to September 2017.
• Inclusion criteria focused on RCTs of LTRAs for eczema in adults and children, comparing them to placebo or conventional treatments.
• Primary outcomes included disease severity, symptom control, and adverse effects; secondary outcomes covered corticosteroid use, pruritus, quality of life, and emollient needs.

Main Results:

• Only five studies involving 202 participants met the criteria, all assessing oral montelukast.
• Short-term montelukast showed no significant difference in eczema severity compared to placebo (low-quality evidence).
• Evidence regarding montelukast versus conventional treatment was very low quality, with mixed results on disease severity and no significant difference in pruritus or topical corticosteroid use.

Conclusions:

• The current evidence base for LTRAs in eczema is limited, primarily to montelukast in moderate-to-severe cases.
• There is no robust evidence to support the use of LTRAs as an effective treatment for eczema.
• Further large-scale, long-duration RCTs are needed to clarify the role of LTRAs across all eczema severities.