Oral drugs belonging to the class of leukotriene antagonists are as effective in asthma as inhaled steroids and bronchodilators, suggest studies. Researchers found that people preferred oral leukotriene-receptor antagonists to inhalers. Improved adherence rates were found in patients on these oral drugs compared with those on bronchodilator-steroid combinations.
India has a large population of patients with chronic respiratory diseases. More than 15 million are believed to suffer from asthma alone in India. Asthma is defined as an inflammatory disorder of the airways. It causes attacks of wheezing, shortness of breath, chest tightness, and coughing. It inflames and narrows the airways.
AdvertisementMost asthma medications work by relaxing airways (bronchodilators) or reducing inflammation (corticosteroids). Inhaled medications are generally preferred over tablet or liquid medicines. These act directly on the airway surface and airway muscles; they also produce the least side effects.
Inhaled drugs include the following:-
• Beta-2 agonists,
• Corticosteroids, and
Apart from these, oral medications are available. These include: Aminophylline, leukotriene antagonists (LTRA), beta-2 agonists (e.g. long-acting beta2-agonist), and corticosteroid tablets
Asthma treatment guidelines recommend inhaled glucocorticoids as the first-line controller medication for asthma control in patients with mild persistent asthma. A recent trial evaluate the real-world effectiveness of a leukotriene-receptor antagonist (LTRA) as compared with either an inhaled glucocorticoid for first-line asthma-controller therapy or a long-acting beta2-agonist (LABA) as add-on therapy in patients already receiving inhaled glucocorticoid therapy.
Two parallel, multicenter, pragmatic trials were performed. Results were published in the New England Journal of Medicine, a leading medical journal. Study results at 2 months suggest that LTRA was equivalent to an inhaled glucocorticoid as first-line controller therapy and to LABA as add-on therapy for diverse primary care patients.
LTRAs are more expensive than steroid inhalers. But this scenario could easily change with its increase use and LTRA drugs like montelukast and zafirlukast can soon be marketed at a lower price. The new findings bring out increased options in the management of first time diagnosed asthmatics with better long term compliance.
With these findings the researchers urge general practitioners to consider switching asthma patients from long-acting beta-agonist inhalers to oral leukotriene-receptor antagonist treatment. Authors say that 'LTRAs are easy to use and can help patients control their asthma effectively and improve their quality of life'.
Source: The New England Journal of Medicine
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