18 THERAPY

Zileuton improves pulmonaty function in aspirin-intolerant asthma

The addition of the leukotriene antagonist zileuton to corticosteroid therapy improved pulmonary function in patients with aspirin-intolerant asthma (AlA), report researchers from Sweden, Poland and the US. They note that the results of their study provide 'the first evidence that leukotrienes play an important role in persistent airway obstruction and chronic nasal symptoms ' in patients with AlA.

In this study, 40 such patients received oral zileuton 600mg 4 times daily and placebo for 6 weeks each in a crossover fashion. * The treatment periods were separated by a 4-week washout period. 39/40 patients were receiving concomitant therapy with inhaled or oral corticosteroids.

Increase in FEV 1 Compared with placebo administration, patients

had experienced a significant increase from baseline in FEV I within 4 hours' of zileuton administration, and this was maintained over 6 weeks' therapy. Loss of smell and rhinorrhoea improved significantly with zileuton, compared with placebo, administration.

17 patients who underwent cumulative lysine­aspirin bronchoprovocation after 4 weeks ' therapy were able to tolerate significantly higher doses of aspirin during zileuton, compared with placebo, administration. However, bronchial reactivity did not differ during zileuton, compared with placebo, administration among 18 patients who underwent bronchoprovocation with the cysteinyl-Ieukotriene LTD4•

There was also a significant decrease in bronchial responsiveness to histamine during zileuton, compared with placebo, administration. * This study was supported in pan by Abbott Pharmaceuticals. Dahl61 B, Nizankowska E. Szczeklik A, ZetIemrtim 0, Bochenek G, et al. Benefits from adding the 5·lipoxygenase inhibitor zileuton to conventional therapy in aspirin·intolerant asthmatics. American Journal of Respiratory and Critical Care Medicine 157: 1187·1194, Part 2, Apr 1998 ....,...,

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