Journal Article

Leukotriene Antagonists as First-Line or Add-on Asthma-Controller Therapy

Sims, Erika J, Hillyer, Elizabeth V, Juniper, Elizabeth F, Mugford, H. Miranda, Murdoch, Jamie, Harvey, Ian, Musgrave, Stanley D, Blyth, Annie, Kemp, Linda, Price, David, Ayres, Jon G, Gilbert, Richard F.T, Wilson, Edward C.F, Freeman, Daryl, Wolfe, Stephanie, Shepstone, Lee

2011

Overview

In this pragmatic trial, patients with asthma who required first-line controller therapy or were already using an inhaled glucocorticoid and needed additional therapy received a leukotriene-receptor antagonist (LTRA) or an inhaled glucocorticoid as first-line treatment or an LTRA or a long-acting beta 2 -agonist as an add-on. Results of double-blind, randomized, controlled trials provide, appropriately, the bedrock of evidence in determining the efficacy of therapeutic interventions. Proof of efficacy in the trial setting of optimized adherence and follow-up for selective patient populations does not, however, guarantee that a particular therapy will be effective in the diverse patient populations seen in clinical practice. 1 – 3 In the case of asthma, for example, the eligibility criteria in most such trials exclude an estimated 95% of patients with a current diagnosis of asthma, including smokers and those who have “insufficient” bronchodilator reversibility or impaired pulmonary function. 4 , 5 Moreover, the design of . . .

• Publisher: Massachusetts Medical Society
• Subject: Administration, Inhalation / Administration, Oral / Adolescent / Adrenergic beta-Agonists - therapeutic use / Adult / Aged / Anti-Asthmatic Agents - therapeutic use / Asthma / Asthma - drug therapy / Bronchodilator Agents - therapeutic use / Double-Blind Method / Drug Therapy, Combination / Female / Glucocorticoids - therapeutic use / Humans / Leukotriene Antagonists - therapeutic use / Male / Medical treatment / Middle Aged / Primary care / Quality of Life / Surveys and Questionnaires / Therapeutic Equivalency / Young Adult