The role of antileukotrienes in the treatment of asthma

Objective: This article reviews the literature on the role of antileukotrie nes (anti-LTs), specifically montelukast, zafirlukast, and zileuton, in the treatment of asthma. Data Sources: Relevant and appropriate controlled clinical studies were use d. Only literature in the English language was reviewed. Study Selection: Material was taken from academic/scholarly journals, appro priate reviews, and published abstracts. Results: In guidelines established by the National Asthma Education and Pre vention Program and the National Heart, Lung, and Blood Institute, a stepwi se approach to asthma management is recommended, with recommendations varyi ng depending on degree of disease severity. The anti-LTs, the newest class of drugs for the treatment of asthma, play a circumscribed role in the guid elines as they were only recently available when the latest guidelines were published. Subsequently, however, extensive clinical experience with the a nti-LTs has been amassed. Multiple clinical studies have demonstrated that the anti-LTs improve pulmonary function and quality of life, and reduce ast hma symptoms, asthma exacerbations, and use of beta (2)-agonists and oral s teroids. The anti-LTs may be particularly useful in asthma patients with as pirin sensitivity or concomitant allergic rhinitis, as well as in pediatric patients. These agents have additive effects with inhaled corticosteroids and may permit a reduction in inhaled corticosteroid dosages. Conclusions: The anti-LTs have several features that are likely to promote adherence to treatment and are generally well tolerated. The available clin ical data suggest that anti-LTs should be considered as a therapeutic optio n or as additive therapy in patients with mild to severe asthma.