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Leukotriene-Receptor Antagonists Effective in Asthma

May be equivalent to inhaled glucocorticoid, long-acting beta2-agonist

WEDNESDAY, May 4 (HealthDay News) -- Use of a leukotriene-receptor antagonist (LTRA) may be as effective as an inhaled glucocorticoid as first-line controller therapy, and as effective as a long-acting beta2-agonist (LABA) as an add-on therapy, for the treatment of asthma patients, according to the findings of two pragmatic trials published in the May 5 issue of the New England Journal of Medicine.

David Price, F.R.C.G.P., from the University of Aberdeen in the United Kingdom, and colleagues conducted parallel trials to compare the effectiveness of asthma drugs in a real-world setting: LTRA (148 patients) versus an inhaled glucocorticoid for first-line therapy (158 patients) in a first-line controller therapy trial, and LTRA (170 patients) versus LABA (182 patients) in those already using an inhaled glucocorticoid. The patients had impaired asthma-related quality of life or inadequate asthma control.

The researchers found that quality-of-life scores improved over two years in both trials, with differences in the two scores meeting equivalence at two months and approaching equivalence at two years. There were no significant differences between the two groups in exacerbation rates or asthma control questionnaire scores.

"Study results at two months suggest that LTRA was equivalent to an inhaled glucocorticoid as first-line controller therapy and to LABA as add-on therapy for diverse primary care patients. Equivalence was not proved at two years. The interpretation of results of pragmatic research may be limited by the crossover between treatment groups and lack of a placebo group," the authors write.

Several authors disclosed financial relationships with pharmaceutical companies; research was supported by Merck Sharp & Dohme, AstraZeneca, and Research in Real Life.

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