Leukotriene inhibitors and non-steroidal therapies in the treatment of asthma

Expert Opin Pharmacother. 2001 Jan;2(1):47-65. doi: 10.1517/14656566.2.1.47.

Abstract

Asthma is the most common chronic disease of childhood whose morbidity and mortality continues to rise [1]. Drugs used in the treatment of asthma must be targeted at reversing three principle pathophysiologic features: bronchoconstriction, mucus plugging/hypersecretion and inflammation. In the past two decades, the contribution of airway inflammation to the development and progression of asthma symptoms and airway pathology has become a critical focus. Chronic airway inflammation can lead to the progressive decline and irreversible loss of lung function and airway remodelling [2]. In recent years, therapies aimed at diminishing airway inflammation have been at the forefront of asthma management. Steroids have been extensively studied and used as primary anti-inflammatory agents in the management of the asthmatic patient with persistent symptoms of varying severity. Within the last decade, however, several additional non-steroidal classes of drugs have begun to emerge as anti-inflammatory agents for the treatment of asthma. This article will focus on these non-steroidal drugs which have been developed and investigated within the last 5 years. Particular emphasis will be placed on leukotriene receptor antagonists, but anti-IgE and anti-IL-4 therapies, as well as phosphodiesterase inhibitors will also be discussed. Of these new therapies, only two leukotriene receptor antagonists, montelukast (Singulairtrade mark, Merck) and zafirlukast (Accolatetrade mark, AstraZeneca) and the 5-lipoxygenase inhibitor, zileuton (Zyflotrade mark, Abbott Laboratories), have been recommended, approved and are currently available for use in the treatment of paediatric patients with asthma in the United States.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • Acetates / therapeutic use
  • Adult
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Antibodies, Monoclonal / therapeutic use
  • Asthma / drug therapy*
  • Asthma / physiopathology
  • Bronchoconstriction / drug effects
  • Bronchoconstriction / physiology
  • Child
  • Clinical Trials as Topic
  • Cyclopropanes
  • Humans
  • Hydroxyurea / analogs & derivatives*
  • Hydroxyurea / therapeutic use
  • Indoles
  • Leukotriene Antagonists / therapeutic use*
  • Phenylcarbamates
  • Phosphodiesterase Inhibitors / therapeutic use
  • Quinolines / therapeutic use
  • Sulfides
  • Sulfonamides
  • Tosyl Compounds / therapeutic use
  • Treatment Outcome

Substances

  • Acetates
  • Anti-Inflammatory Agents, Non-Steroidal
  • Antibodies, Monoclonal
  • Cyclopropanes
  • Indoles
  • Leukotriene Antagonists
  • Phenylcarbamates
  • Phosphodiesterase Inhibitors
  • Quinolines
  • Sulfides
  • Sulfonamides
  • Tosyl Compounds
  • montelukast
  • zileuton
  • Hydroxyurea
  • zafirlukast