Long-acting beta2-agonists versus anti-leukotrienes as add-on therapy to inhaled corticosteroids for chronic asthma

Ram, Felix S F; Cates, Christopher J; Ducharme, FM

doi:10.1002/14651858.cd003137.pub2

Cited by 55 publications

(40 citation statements)

References 85 publications

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“…New class of asthma medication Not superior to inhaled corticosteroids Indicated for aspirin induced, exercise induced asthma and add on therapy for severe persistent asthma [15]. every 20 minutes for the first hour), which is the best and most cost-effective method to achieve rapid reversal of airflow limitation.Oral glucocorticoids (1mg/kg prednisolone daily for 7-10 days) should be used in all but the mildest exacerbations as they significantly reduce the number of relapses and decreases beta-agonist use without an apparent increase in side effects.…”

Section: Leukotriene Inhibitorsmentioning

confidence: 99%

Best Treatment Guidelines For Bronchial Asthma

Rai

Patil

Vardhan

et al. 2007

Medical Journal Armed Forces India

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Asthma is a common disease worldwide with significant ethnic and regional variations. An increasing morbidity and mortality, as well as health care burden from asthma have been recognized lately. Several evidence based guidelines have been developed with an aim to standardize and improve the quality of management. These guidelines seek to translate the advances in the understanding of pathogenesis of asthma and in the development of new agents and strategies into practical application at all levels of healthcare. These advocate an assessment of the patients to classify the severity of diseases followed by a step-wise approach to treatment. With the current management we hope to achieve minimum or nil day time and night time symptoms, prevent acute exacerbations and attain normal or near normal lung function, thus improving the overall quality of life. MJAFI 2007; 63 : 264-268

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Section: Leukotriene Inhibitorsmentioning

confidence: 99%

Best Treatment Guidelines For Bronchial Asthma

Rai

Patil

Vardhan

et al. 2007

Medical Journal Armed Forces India

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“…Essa relação de eficácia foi confirmada por Ram et al 38 , que avaliaram 13 estudos randomizados e controlados comparando associações de ARLT + LABA versus CI + LABA em 5.895 pacientes asmáticos adultos e concluíram que, em adultos asmáticos inadequadamente controlados com CI, a adição de LABA é superior à adição de ARLT para: I) prevenir exacerbações da asma; II) melhorar a função pulmonar; III) melhorar os sintomas asmá-ticos; e IV) permitir menor utilização de medicamentos de resgate (ß2-agonistas de curta duração).…”

Section: Adição De Arlt Aos CI Para Uso Na Asmaunclassified

Antileukotrienes in the treatment of asthma and allergic rhinitis

Ribeiro¹,

Toro²,

Baracat³

2006

J Pediatr (Rio J)

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Objective: To compare leukotriene antagonists (LTA) to other groups of drugs used in asthma and allergic rhinitis treatment.Sources: MEDLINE, LILACS and Cochrane Library. Keywords: leukotrienes, antileukotrienes, asthma treatment, allergic rhinitis treatment, asthma and allergic rhinitis. An attempt was made to group the main studies and reviews about this topic Summary of the findings: LTA are more efficient than placebo and enhance the effects of inhaled corticosteroids. The association of inhaled corticosteroids with long-acting ß2 agonists is more efficient than the association of inhaled corticosteroids + LTA. Although use of LTA in acute asthma attacks and allergic rhinitis seems reasonable, more studies are needed to confirm this benefit. LTA reduce hospitalization time and the number of wheezing attacks in infants with acute viral bronchiolitis caused by respiratory syncytial virus, as well as recurrent wheezing after acute viral bronchiolitis. LTA are less efficient than intranasal corticosteroids for allergic rhinitis management. LTA are efficient in exercise-induced asthma, although they are not the first-line treatment. Conclusion:Controlled and randomized studies show that inhaled corticosteroids are the drugs of choice to treat persistent asthma and allergic rhinitis. There is not enough evidence to recommend the use of LTA as first-line drug (monotherapy) in children with asthma (level I). For children who cannot use inhaled corticosteroids, LTA may be a good alternative (level II).J Pediatr (Rio J). 2006;82(5 Suppl):S213-21: Asthma, exerciseinduced asthma, rhinitis, antileukotrienes, montelukast, zafirlukast. ResumoObjetivo: Comparar os antagonistas de leucotrienos (ARLT) aos outros grupos de medicamentos utilizados para tratar a asma e a rinite alérgica.Fontes dos dados: MEDLINE, LILACS e Biblioteca Cochrane. Palavras chaves: leucotrienos, antileucotrienos, tratamento da asma, tratamento da rinite alérgica, asma e rinite alérgica. Procurou-se agrupar os principais trabalhos e revisões sobre o assunto.Síntese dos dados: Os ARLT são mais eficazes do que placebo e potencializam os efeitos dos corticosteróides inalados. A associação de corticosteróides inalados com agentes ß2-agonistas de longa duração (LABA) é mais eficaz do que a associação de cortiscoteróides inalados + ARLT. Embora pareça racional o uso de ARLT na crise aguda de asma e rinite alérgica, mais estudos são necessários para comprovar esse benefício. Os ARLT promovem redução no tempo de hospitalização e no número de crises de sibilância em lactentes com bronquiolite viral aguda pelo vírus respiratório sincicial e na sibilância recorrente após bronquiolite viral aguda. Os ARLT são menos eficazes que os corticosteróides intranasais no manejo da rinite alérgica. Os ARLT são eficazes na asma induzida por exercício (AIE), embora não constituam a primeira linha de tratamento. Conclusão:Estudos controlados e randomizados mostram que os corticosteróides inalados são as drogas de escolha para o tratamento da asma persistente e rinite a...

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“…In a perspective article Martinez recommended addition of leukotriene -receptor antagonists or low dose theophylline to therapy for asthma that is not controlled with the use of inhaled corticosteroids which is completely opposite to that of the National Asthma Education and Prevention Program expert panel, prefers the addition of long-acting beta-agonists, instead of leukotriene modifiers, to the treatment of asthma not controlled by inhaled corticosteroids. It should prevent one exacerbation for every 38 patients treated 18 . No study has shown that the combination of inhaled corticosteroids and long-acting beta-agonists results in increased deaths from asthma, and the data from the SMART trial showed to increased risk of death from asthma with salmeterol, as compared with placebo, in patients taking inhaled corticosteroids.…”

Section: Clinical Strategymentioning

confidence: 99%

Safety of Long-Acting Beta-Agonists

2006

N Engl J Med

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Long-acting beta2-agonists versus anti-leukotrienes as add-on therapy to inhaled corticosteroids for chronic asthma

Cited by 55 publications

References 85 publications

Best Treatment Guidelines For Bronchial Asthma

Best Treatment Guidelines For Bronchial Asthma

Antileukotrienes in the treatment of asthma and allergic rhinitis

Safety of Long-Acting Beta-Agonists

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