This article summarizes recent evidence supporting that antileukotriene dru
gs represent a new treatment of asthma which may be particularly effective
when combined with drugs that have complementary effects on airway obstruct
ion and inflammation.
Firstly, it has been documented that glucocorticosteroids do not inhibit in
vivo production of leukotrienes in asthmatics. In line with such findings,
addition of antileukotriene drugs to a group of aspirin-intolerant asthmat
ics maintained on conventional therapy was found to result in an improvemen
t of the asthma over and above the effect of the baseline treatment with in
haled and/or oral glucocorticosteroids. Likewise, in a 6-week trial in a gr
oup of severe asthmatics, the asthma deterioration caused by a reduction of
the dose of inhaled steroids by half, was prevented by addition of a leuko
triene antagonist to the lowered dose of glucocorticosteroids. Current evid
ence therefore supports that antileukotriene drugs treat components of the
pathophysiology which are left unaffected by treatment with glucocorticoste
roid.
Secondly, in experimental studies as well as in a recent allergen bronchopr
ovocation study in asthmatics, it has been found that the combination of an
tihistaminics with antileukotriene drugs will result in a profound inhibiti
on of both the early and the late phase of allergen-induced airway obstruct
ion. It is hypothesized that such a combination may be useful against bronc
hoconstriction induced by other asthma trigger factors as well as in the tr
eatment of asthma and rhinitits.