Leukotriene receptor antagonist monotherapy ups asthma control

(HealthDay)—As monotherapy, leukotriene-receptor antagonists (LTRAs) improve asthma control versus placebo, according to a review and meta-analysis published online Sept. 22 in the Annals of Internal Medicine.

Michael Miligkos, M.D., from the University of Thessaly School of Medicine in Larissa, Greece, and colleagues conducted a systematic review and meta-analysis to determine the benefits and harms of LTRAs as monotherapy or combined with inhaled corticosteroids compared with placebo for adults and adolescents with asthma. Fifty trials met the eligibility criteria for inclusion.

The researchers found that LTRAs reduced the risk of an exacerbation in random-effects meta-analyses of six trials of LTRA monotherapy (summary risk ratio, 0.60; 95 percent confidence interval, 0.44 to 0.81). The summary relative risk for exacerbation was 0.80 (95 percent confidence interval, 0.60 to 1.07) in four trials of LTRAs as add-on therapy to inhaled corticosteroids. Forced expiratory volume in one second (FEV₁) was increased with LTRAs as monotherapy or add-on therapy to inhaled corticosteroids; the FEV₁ percentage of predicted values was only improved in LTRA monotherapy trials. Similar adverse events rates were seen for the intervention and comparator groups.

"Leukotriene-receptor antagonists as monotherapy improved asthma control compared with placebo, but which patients are most likely to respond to treatment with LTRAs remains unclear," the authors write.