An article in the May 5 issue of the New England Journal of Medicine finds leukotriene-receptor antagonists (LTRAs) such as montelukast (Singulair) as effective as ICS as a first-line treatment for asthma and as effective as LABAs as an add-on for those already taking inhaled corticosteroids in real-world trials. The researchers from the University of East Anglia (UAE) conducted 2 2-year pragmatic trials in the UK involving more than 650 patients ranging in age from 12 to 80.
According to lead author David Price, adherence to the once-a-day LTRA tablets was as much as 60% higher than to the inhalers. A UAE press release suggests that “The results indicate that LTRAs could provide an effective alternative to steroid inhalers and other ‘preventer’ inhalers when used in addition to steroid inhalers, which could be useful for the more than 80 per cent of patients who have problems using inhalers, are unable to use them due to side effects, or do not want to take steroids.”
Dr Samantha Walker, Director of Research and Policy at Asthma UK, responded: “Inhaled treatments are safe and effective for the majority of people with asthma, however this authoritative study reveals preliminary evidence that non-steroid daily tablets can provide a realistic, alternative choice of treatment for some of the 4.3 million adults with asthma in the UK.” UK guidelines currently recommend LTRAs as third or fourth level treatments for asthma, and Walker recommended that patients continuing taking their medications as prescribed.
Read the NEJM abstract.
Read a University of East Anglia press release.
Read Asthma UK press release.
