Zafirlukast in clinical practice - Results of the Accolate Clinical Experience and Pharmacoepidemiology Trial (ACCEPT) in patients with asthma

BACKGROUND. Zafirlukast is an oral leukotriene receptor antagonist used in the treatment of patients with mild to moderate asthma. To investigate its effects in a clinical practice setting, we evaluated zafirlukast in a heter ogeneous group of patients who had asthma of different degrees of severity and who were receiving concomitant asthma medications. METHODS. A total of 3759 patients were enrolled at 924 sites. Patients rece ived zafirlukast 20 mg twice a day for 4 weeks. Pulmonary function was meas ured twice a day, and overall asthma symptom scores, number of nighttime aw akenings, severity of morning asthma symptoms, and beta(2)-agonist use were recorded daily. RESULTS. In the efficacy analysis (3207 evaluable patients), all parameters showed statistically significant improvement that continued throughout the 4 weeks of the trial. A total of 71% of patients had improved pulmonary fu nction and 72% had improved asthma symptoms. Improvement was consistent reg ardless of asthma severity category and regardless of concomitant asthma me dication category. More than 70% of both physicians and patients indicated there was clinical improvement in pulmonary measures as well as in asthma s ymptoms. Common adverse events reported were headache (3.7%), nausea (1.4%) , pharyngitis (1.4%), and sinusitis (1.1%). CONCLUSIONS. Zafirlukast 20 mg twice a day is well tolerated and improves p ulmonary function and asthma symptoms, regardless of asthma severity catego ry and regardless of concomitant asthma medication category.