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Efficacy of anti-LT agents in the treatment of chronic asthma

  • Clinical Sciences
  • The Immunobiology of Leukotriene Inhibitors
  • Published:
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Summary

Anti-LT agents are the first new class of asthma medication to be approved in the last 20 yr. Current asthma treatment guidelines recommentd antileukobriene agents as anti-inflammatory therapy for patients with mild, persistent asthma. The role that these drugs will play in clinical practice will become more apparent as additional experience is gained in their use. The results of clinical studies illustrate their potential: anti-LT agents reduce asthma symptoms, improve airway function, and decrease the need for concomitant β2-agonists and inhaled corticosteroids; the incidence of asthma exacerbations may also be reduced. Finally, because these agents are administered orally, they offer the potential for improved patient compliance relative to the more complicated forms of drug administration.

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References

  1. National Institutes of Health, National Heart, Lung and Blood Institute. Highlights of the expert panel report II. Guidelines for the diagnosis and management of asthma, 1997. Bethesda, MD.

  2. Spector SL. Leukotriene inhibitors and antagonists in asthma. Ann Allergy Asthma Immunol 1995; 75:463–473.

    PubMed  CAS  Google Scholar 

  3. Todd G, Dunlop K, McNaboe J, Ryan MF, Carson D, Shields MD. Growth and adrenal suppression in asthmatic children treated with high-dose fluticasone propionate. Lancet 1996; 348:27–29.

    Article  PubMed  CAS  Google Scholar 

  4. Wolthers OD. Long-, intermediate-, and short-term growth studies in asthmatic children treated with inhaled glucocorticosteroids. Eur Respir J 1996; 9:821–827.

    Article  PubMed  CAS  Google Scholar 

  5. Garbe E, LeLorier J, Boivin J-F, Suissa S. Inhaled and nasal glucocorticoids and the risks of ocular hypertension and open-angle glaucoma. JAMA 1997; 277:722–727.

    Article  PubMed  CAS  Google Scholar 

  6. Cumming RG, Mitchell P, Leeder SR. Use of inhaled corticosteroids and the risk of cataracts. N Engl J Med 1997; 337 (1):814.

    Article  Google Scholar 

  7. Peters-Golden M, Song K, Marshall T, Brock T. Translocation of the cytosolic phospholipase A2 to the nuclear envelope elicits topographically localized phospholipid hydrolysis. Biochem J 1996; 318:797–803.

    PubMed  CAS  Google Scholar 

  8. Laitinen L, Laitinen A., Haahtela I, Vilkka V, Spur BW, Lee TH. Leukotriene E4 and granulocytic infiltration into asthmatic airways. Lancet 1993; 341:989, 900.

    Article  PubMed  CAS  Google Scholar 

  9. Coleman RA., Eglen RM, Jones RL, Narumiya S, Shimizu T, Smith WL, Dahlen SE, Drazen JM, Gardiner PJ, Jackson WT, Jones TR, Krell RD, Nicosia S, Prostanoid and leukotriene receptors: a progress report from the IUPHAR working parties on classification and nomenclature. Adv Prost Throm Leuko Res 1995; 23:283–285.

    CAS  Google Scholar 

  10. Smith LJ, Geller S, Ebright L, Glass M, Thyrum PT. Inhibition of leukotriene D4-induced bronchoconstriction in normal subjects by the oral LTD4 receptor antagonist ICI 204,219. Am Rev Respir Dis 1990; 141:988–992.

    PubMed  CAS  Google Scholar 

  11. O’Shaughnessy TC, Georgiou P, Howland K, Dennis M, Compton CH, Barnes NC. Effect of pranlukast, an oral leukotriene receptor antagonist, on leukotriene D4 (LTD4) challenge in normal volunteers. Thorax 1997; 52:519–522.

    PubMed  CAS  Google Scholar 

  12. Finnerty JP, Wood-Baker R, Thomson H, Holgate ST. Role of leukotrienes in exercise-induced asthma. Inhibitory effect of ICI 204219, a potent leukotriene D4 receptor antagonist. Am Rev Respir Dis 1992; 145:746–749.

    PubMed  CAS  Google Scholar 

  13. Israel E, Dermarkarian R, Rosenberg M, Sperling R, Taylor G, Rubin, P, Drazen JM. The effects of a 5-lipoxygenase inhibitor on asthma induced by cold air. N Engl J Med 1990; 323:1740–1744.

    Article  PubMed  CAS  Google Scholar 

  14. Israel E, Fischer AR, Rosenberg MA, Lilly CM, Callery JC, Shapiro J, Cohn J, Rubin P, Drazen JM. The pivotal role of 5-lipoxygenase products in the reaction of aspirin-sensitive asthmatics to aspirin. Am Rev Respir Dis 1993; 148:1447–1451.

    PubMed  CAS  Google Scholar 

  15. Taylor IK, O’Shaughnessy KM, Fuller RW, Dollery CT. Effect of cysteinylleukotriene receptor antagonist ICI 204,219 on allergen-induced bronchoconstriction and airway hyperreactivity in atopic subjects. Lancet 1991; 337:690–694.

    Article  PubMed  CAS  Google Scholar 

  16. Hui KP, Barnes NC. Lung function improvement in asthma with a cysteinylleukotriene receptor antagonist. Lancet 1991; 337:1062, 1063.

    Article  PubMed  CAS  Google Scholar 

  17. Sorkness CA, Reiss TF, Zhang J, et al. Bronchodilation with a selective and potent leuktriene D4 (LTD4) antagonist (MK-0476) in patients with asthma (abstr). Am J Respir Crit Care Med 1994; 149:A216.

    Google Scholar 

  18. Barnes NC, Pujet J-C., International Study Group. Pranlukast, a novel leukotriene receptor antagonist: results of the first European, placebo controlled, multicentre study in asthma. Thorax 1997; 52:523–527.

    Article  PubMed  CAS  Google Scholar 

  19. Fish JE, Kemp JP, Lockey RF, Glass M, Hanby LA, Bonuccelli CM, Zafirlukast Trialists Group. Zafirlukast for the treatment of mild to moderate asthma: a 13-week multicenter study. Clin Ther 1997; 19(4):675–690.

    Article  PubMed  CAS  Google Scholar 

  20. Suissa S, Dennis R, Ernst P, Sheehy O, Wood-Dauphinee S. Effectiveness of the leukotriene receptor antagonist zafirlukast for mild-to-moderate asthma: a randomized, double-blind, placebo controlled trial. Ann Intern Med 1997; 126:177–183.

    PubMed  CAS  Google Scholar 

  21. Israel E, Cohn J, Dube L, Drazen JM, Zileuton Clinical Trial Group. Effect of treatment with zileuton, a 5-lipoxygenase inhibitor, in patients with asthma. A randomized controlled trial. JAMA 1996; 275:931–936.

    Article  PubMed  CAS  Google Scholar 

  22. Liu MC, Dube LM, Lancaster J. Acute and chronic effects of a 5-lipoxygenase inhibitor in asthma: a 6-month randomized multicenter trial. J Allergy Clin Immunol 1996; 98:859–871.

    Article  PubMed  CAS  Google Scholar 

  23. Spector SL, Smith LJ, Glass M, ‘Accolate’ Asthma Trialist Group. Effects of 6 weeks of therapy with oral doses of ICI-204,219, a leukotriene D4 receptor antagonist, in subjects with bronchial asthma. Am J Respir Crit Care Med 1994; 150:618–623.

    PubMed  CAS  Google Scholar 

  24. Spector S, Miller CJ, Glass M. 13-Week dose-response study with Accolate (zafirlukast) in patients with mild to moderate asthma. Allergy 1995; 50 (Suppl 26):117.

    Google Scholar 

  25. Spector S, Fish JE. A new approach: clinical review of zafirlukast (Accolate, ICI204,219). Eur Respir J 1997;7:46, 269–273.

    Google Scholar 

  26. Barnes NC, Black B, Syrett N, et al. Reduction of exacerbation of asthma in multinational clinical trials with zafirlukast (Accolate). Am J Respir Crit Care Med 1996; 153:A802.

    Google Scholar 

  27. Nathan RA, Glass M, Snader L. Effects of 13 weeks of treatment with ICI 204,219 (Accolate) or cromolyn sodium (Intal) in patients with mild to moderate asthma. J Allergy Clin Immunol 1996; 97:368.

    Google Scholar 

  28. Schwartz HJ, Petty T, Due LM, Swanson LJ, Lancaster JF, Zileuton Study Group. A randomized controlled trial comparring zileuton with theophylline in moderate asthma. Arch Inter Med 1998; 158:141–148.

    Article  CAS  Google Scholar 

  29. Virchow J, Hassall SM, Summerton L, Harris A. Improved asthma control over 6 weeks with Accolate (zafirlukast) in patients on hihg-dose inhaled corticosteroids. J Investig Med 1997; 45:286A.

    Google Scholar 

  30. Reiss TF et al. Eur Respir J 1997; 10:437S-438S.

    Article  Google Scholar 

  31. Ohno S et al. Eur Respir J 1997; 4405.

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Spector, S.L. Efficacy of anti-LT agents in the treatment of chronic asthma. Clinic Rev Allerg Immunol 17, 235–246 (1999). https://doi.org/10.1007/BF02737607

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