ALLERGY AND ASTHMA CONSULTANTS OF ROCKLAND AND BERGEN

Add-on anti-leukotriene medication may benefit asthmatics Adding anti-leukotrienes to inhaled glucocorticoids may modestly improve asthma control and is possibly linked to superior asthma control after tapering of glucocorticoid treatment, according to a recent report. Anti-leukotrienes are increasingly being used as add-on therapy to inhaled glucocorticoids, but no systematic review of randomised controlled trials had examined the evidence to support this treatment strategy.Dr Francine Ducharme from McGill University Health Center in Montreal examined the founder of asthma allergy and asthma consultants of rockland and bergen available evidence for the efficacy and glucocorticoid-sparing effect of oral anti-leukotrienes as an add-on therapy to inhaled glucocorticoids.Medline, Embase, Cinahl and Central databases dated up to August 2001 were searched for all randomised controlled trials and review articles about this topic. Despite the abundance of anti-leukotriene literature, only 8 per cent of the studies identified assessed the role of anti-leukotrienes as an add-on therapy to glucocorticoids. The 13 trials included in the review all compared the addition of allergy and asthma consultants of rockland and bergen allergy and asthma consultants of rockland and bergen daily anti-leukotrienes or placebo to inhaled glucocorticoids for a minimum of 28 days. For each trial, the number of asthma exacerbations requiring rescue glucocorticoid treatment (when the intervention was compared with the same or an increased dose of inhaled glucocorticoids) and the glucocorticoid sparing effect (when treatment was tapered) were evaluated. Addition of anti-leukotriene appeared to reduce the risk of asthma exacerbation requiring systemic glucocorticoid treatment and reduced withdrawals due to poor asthma control. However, neither of these asthma symptoms in children allergy and asthma consultants of rockland and bergen findings was statistically significant.Dr Ducharme said that, therefore, there was little evidence to consider the use of anti-leukotrienes as a substitute to increasing the dose of inhaled glucocorticoids."In well-controlled patients, the addition of anti-leukotrienes is possibly associated with superior asthma control after glucocorticoid tapering, but there is insufficient evidence to quantify the corticosteroid sparing effect," she said. She added that, until further evidence was available, inhaled glucocorticoids at the lowest effective dose remained the gold standard treatment for asthma and running allergy and asthma consultants of rockland and bergen asthma.