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reviews: Sundeep S. Salvi, Mamudipudi T. Krishna, Anthony P. Sampson, and Stephen T. Holgate The Anti-inflammatory Effects of Leukotriene-Modifying Drugs and Their Use in Asthma Chest 2001; 119: 1533-1546 [Abstract] [Full text] [PDF]

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Leukotriene-Modifying Drugs and their Use in Asthma

Dr S K Agarwal   (18 March 2002)

Leukotriene-Modifying Drugs and their Use in Asthma 18 March 2002
Dr S K Agarwal, Head, Department of Chest Diseases, Institute of Medical Sciences, BHU, Varanasi Send letter to journal: Re: Leukotriene-Modifying Drugs and their Use in Asthma sk_agarwal{at}satyam.net.in Dr S K Agarwal	Leukotriene-modifying drugs improve lung function, reduce the need for rescue bronchodilators and decrease sputum eosinophil count in mild to moderate asthma. There is a reasonable expectation that agents from this class might have additive effects with inhaled steroids for this group since the overproduction of cysteinyl leukotrienes in airways is not inhibited by glucocorticoids. However, a recent study (1) found montelukast to be having marginal utility in the management of adult patients with controlled persistent asthma and there was no significant reduction in the requirement of inhaled beta-2-agonist therapy. Leukotriene blockers are the first new class of asthma therapy in nearly 2 decades. These agents block the action or inhibit the synthesis of the cysteinyl leukotrienes, bioactive mediators with proinflammatory effects that play an important role in the pathophysiology of asthma. However, in a study by Robinson et al (2) addition of montelukast did not provide additional benefit in patients with moderate or severe asthma already taking steroids. References: 1. Mathison, D A and Koziol, J A. Marginal Utility of Montelukast for Persistent Asthma. Chest. 2002; 121:334-337. 2. Robinson D S, Campbell D and Barnes, P J. Addition of leukotriene antagonists to therapy in chronic persistent asthma: a randomized double- blind placebo-controlled trial. Lancet 2001; 357:2007-2011