Biomedical subjects

Antileukotriene Working Group

Publications and source records attributed to Antileukotriene Working Group.

6 recordsLinked to original sources

PubMed2001

Discovery of leukotrienes and development of antileukotriene agents.

OBJECTIVE: This article presents information on the origin of leukotrienes (LTs) and the development of antileukotriene (anti-LT) agents. After reading this article, readers should have an understanding of the chemical mediators involved in the pathogenesis of asthma, the structural features of LTs, and the role of anti-LTs in the management of asthma symptoms. DATA SOURCES: Studies considered relevant and appropriately controlled were used. Only literature in the English language was reviewed. STUDY SELECTION: Material was taken from academic/scholarly journals and abstracts. RESULTS: One of the important chemical mediators implicated in the pathogenesis of asthma is the slow-reacting substance of anaphylaxis, which was subsequently found to comprise LTs C4, D4, and E4. 5-lipoxygenase products from arachidonic acid metabolism, LTs are released from the lung tissue of asthmatic patients and purified human lung mast cells by antigens. The LTs directly induce contraction of bronchial smooth muscle. The use of anti-LT agents, particularly the receptor antagonists zafirlukast and montelukast and the biosynthesis inhibitor zileuton, reverses the bronchoconstrictive effects of LTs and significantly improve asthma symptoms. CONCLUSIONS: Extensive in vitro and in vivo evidence supports the role of LTs in the pathogenesis of asthma. Their discovery has had a significant impact on treatment strategies, including the use of anti-LT agents, for the management of asthma.

Animals↗

PubMed2001

Efficacy of antileukotriene agents in asthma management.

OBJECTIVE: This article reviews information on the role of three antileukotrienes (anti-LTs), montelukast, zafirlukast, and zileuton, in the management of asthma. After reading this article, readers should have an understanding of the efficacy of anti-LTs in specific patient populations. DATA SOURCES: Relevant and appropriately controlled clinical studies on the efficacy of anti-LTs were used. Only literature in the English language was reviewed. STUDY SELECTION: Material was taken from peer-reviewed journals and published abstracts. RESULTS: The efficacy of anti-LTs has been established in numerous randomized, controlled, multicenter trials involving patients with mild-to-moderate disease. These agents reduce asthma symptoms, beta2-agonist use, and asthma exacerbations, in addition to improving pulmonary function. The anti-LTs are also effective when added to low-dose or high-dose corticosteroid regimens in symptomatic asthma patients. They have proven efficacy in patients with aspirin-sensitive asthma, and they appear able to reduce nasal congestion in asthma patients with concomitant upper airway symptoms. Some anti-LTs have been shown to be effective in pediatric asthma patients. CONCLUSIONS: In reviewing available clinical results as well as real-world experience in managing asthma patients, the Antileukotriene Working Group concludes that anti-LTs may be used in patients with mild persistent asthma as well as in combination with other asthma medications at all levels of disease severity for long-term maintenance of asthma control.

Adrenal Cortex Hormones↗

PubMed2001

Safety of antileukotriene agents in asthma management.

OBJECTIVE: This article presents information on the safety of zafirlukast, montelukast, and zileuton, three antileukotrienes (anti-LTs) approved in the United States for the prophylaxis and treatment of asthma. After reading this article, readers should have an understanding both of the general safety of anti-LTs and their specific adverse effects. DATA SOURCES: Relevant and appropriate controlled clinical studies on the safety of anti-LTs in asthma were used. Only literature in the English language was reviewed. STUDY SELECTION: Material was taken from academic/scholarly journals and appropriate reviews. RESULTS: Antiasthma agents, including corticosteroids, beta2-agonists, and methylxanthines, may be categorized into two classes: those used for the long-term control and prevention of persistent asthma and those used for the prompt relief of acute symptoms and exacerbations of the disease. Although most agents are safe and well tolerated when used properly, adverse effects may occur with use at higher dose levels. The anti-LTs, including zafirlukast, montelukast, and zileuton, are the first new pharmacologic class in the therapeutic armamentarium for asthma management to be approved in the United States in the past 20 years. Both zafirlukast and montelukast carry pregnancy category B classification whereas zileuton carries pregnancy category C classification. The most common adverse effects observed in clinical trials were headache, pharyngitis, abdominal pain, dyspepsia, and cough. CONCLUSIONS: The results of clinical trials and real-world experience indicate that these agents are generally safe and well tolerated, with an incidence of adverse effects comparable with placebo.

Acetates↗

PubMed2001

Adherence to asthma therapy.

OBJECTIVE: This article presents information on the important impact the lack of adherence to prescribed treatments has on the morbidity and mortality of asthma. After reading this article, readers should have an understanding of the significant role clinicians, as well as patients and their families, play in promoting adherence. DATA SOURCES: A detailed literature search was conducted. Relevant studies were used. Only literature in the English language was reviewed. STUDY SELECTION: Material was taken from academic/scholarly publications, appropriate reviews, and published abstracts. RESULTS: Over the last decade, many researchers have examined ways to improve adherence to asthma therapy, including improving clinician-patient communication, educating the patient, and simplifying the treatment regimen. Nonadherence is a problem in pediatric and adolescent patients, whose needs are different from those of adult patients. Because proper technique is essential with metered-dose inhalers and peak flow meters, special efforts are required by clinicians to promote adherence to these devices. CONCLUSIONS: Promoting adherence involves a good clinician-patient relationship, as well as provision of personalized, practical, and repeated education.

Asthma↗

PubMed2001

The role of antileukotrienes in the treatment of asthma.

OBJECTIVE: This article reviews the literature on the role of antileukotrienes (anti-LTs), specifically montelukast, zafirlukast, and zileuton, in the treatment of asthma. DATA SOURCES: Relevant and appropriate controlled clinical studies were used. Only literature in the English language was reviewed. STUDY SELECTION: Material was taken from academic/scholarly journals, appropriate reviews, and published abstracts. RESULTS: In guidelines established by the National Asthma Education and Prevention Program and the National Heart, Lung, and Blood Institute, a stepwise approach to asthma management is recommended, with recommendations varying depending on degree of disease severity. The anti-LTs, the newest class of drugs for the treatment of asthma, play a circumscribed role in the guidelines as they were only recently available when the latest guidelines were published. Subsequently, however, extensive clinical experience with the anti-LTs has been amassed. Multiple clinical studies have demonstrated that the anti-LTs improve pulmonary function and quality of life, and reduce asthma symptoms, asthma exacerbations, and use of beta2-agonists and oral steroids. The anti-LTs may be particularly useful in asthma patients with aspirin sensitivity or concomitant allergic rhinitis, as well as in pediatric patients. These agents have additive effects with inhaled corticosteroids and may permit a reduction in inhaled corticosteroid dosages. CONCLUSIONS: The anti-LTs have several features that are likey to promote adherence to treatment and are generally well tolerated. The available clinical data suggest that anti-LTs should be considered as a therapeutic option or as additive therapy in patients with mild to severe asthma.

Adrenal Cortex Hormones↗

PubMed2001

Consensus guidelines for asthma therapy.

OBJECTIVE: This article provides information on the consensus reached by the Antileukotriene Working Group on the role of leukotriene (LT) modifiers in the treatment of asthma. DATA SOURCES: Relevant and appropriate controlled clinical studies were used. Only literature in the English language was reviewed. STUDY SELECTION: Material was taken from academic/scholarly journals and appropriate reviews. RESULTS: Only limited use of LT-modifying agents has been recommended in recently published guidelines of the National Asthma Education and Prevention Program and the National Heart, Lung, and Blood Institute. Consequently, the Antileukotriene Working Group was convened to arrive at a consensus on the wider use of LT modifiers in the treatment of asthma. The group' s purpose was 2-fold: to review and disseminate information on the role of LT modifiers in clinical practice. As determined by the group, a thorough understanding of the patient's disease, patient education, and an effective patient-clinician relationship are key elements in overall patient management. CONCLUSIONS: Based on evidence from clinical trials and expert opinions of participants comprising the Antileukotriene Working Group, LT-modifying agents potentially may be used as first-line therapy, in combination regimens, and as an alternative to inhaled corticosteroids in the treatment of asthma.

Asthma↗