Inpharma 1474 - 12 Feb 2005

Inhaled corticosteroids shouldremain first-line asthma therapyClinical trials do not support the substitution of oral

leukotriene antagonists for low-dose inhaledcorticosteroids as first-line therapy for the control ofasthma, according to a systematic review by an authorfrom Canada.

The review included 27 randomised controlled trialsthat compared leukotriene antagonists with inhaledcorticosteroids, given for ≥ 28 days to patients aged≥ 2 years with asthma.

Treatment with inhaled beclometasone 400 µg/day orfluticasone propionate 200 µg/day was superior to oralleukotriene antagonists. Specifically, compared withleukotriene antagonists, inhaled corticosteroids wereassociated with 65% fewer exacerbations requiringsystemic corticosteroids, greater improvements inspirometry and symptoms, fewer night-timeawakenings, and less use of rescue β2 agonists.

Although adverse effects typically associated withinhaled corticosteroids were not measured, whichprevented a fair comparison of long-term safety, theshort-term safety profiles were comparable betweeninhaled corticosteroids and leukotriene antagonists.

The author notes that, "with only three published trialsfor a total of 216 patients, there is insufficient evidence tomake any firm conclusions about the use of leukotrienereceptor antagonists as monotherapy in children withasthma".Ducharme FM. Inhaled corticosteroids versus leukotriene antagonists as first-linetherapy for asthma: a systematic review of current evidence. Treatments inRespiratory Medicine 3: 399-405, No. 6, 2004 800927730

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Inpharma 12 Feb 2005 No. 14741173-8324/10/1474-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved