Efficacy of antileukotriene agents in asthma management

Objective: This article reviews information on the role of three antileukot rienes (anti-LTs), montelukast, zafirlukast, and zileuton, in the managemen t of asthma. After reading this article, readers should have an understandi ng of the efficacy of anti-LTs in specific patient populations. Data Sources: Relevant and appropriately controlled clinical studies on the efficacy of anti-LTs were used. Only literature in the English language wa s reviewed. Study Selection: Material was taken from peer-reviewed journals and publish ed abstracts. Results: The efficacy of anti-LTs has been established in numerous randomiz ed, controlled, multicenter trials involving patients with mild-to-moderate disease. These agents reduce asthma symptoms, beta (2)-agonist use, and as thma exacerbations, in addition to improving pulmonary function. The anti-L Ts are also effective when added to low-dose or high-dose corticosteroid re gimens in symptomatic asthma patients. They have proven efficacy in patient s with aspirin-sensitive asthma, and they appear able to reduce nasal conge stion in asthma patients with concomitant upper airway symptoms. Some anti- LTs have been shown to be effective in pediatric asthma patients. Conclusions: In reviewing available clinical results as well as real-world experience in managing asthma patients, the Antileukotriene Working Group c oncludes that anti-LTs may be used in patients with mild persistent asthma as well as in combination with other asthma medications at all levels of di sease severity for long-term maintenance of asthma control.