16 Nov Study Evaluates Non-Steroidal LTRAs For Asthma
MedicalResearch.com Interview with:
Michael Miligkos, MD, MS
Laboratory of Biomathematics,
University of Thessaly School of Medicine
Larissa, Greece
Medical Research: What is the background for this study? What are the main findings?
Dr. Miligkos: Asthma is one of the most common chronic diseases with and has
considerable social and economic burdens. Although inhaled
corticosteroids constitute the current gold standard of maintenance
treatment, leukotriene-receptor antagonists (LTRAs) have the
advantages of oral once- or twice- daily dosing and, apparent
avoidance of the adverse effects associated with long-term
corticosteroid therapy. In addition, their mechanisms of action
theoretically predicts a good response in patients with specific
asthma “phenotypes”. This systematic review investigated the use of
all marketed LTRAs in usual licensed doses as asthma controller
medications compared with placebo and found that administration of a
LTRA to adults and adolescents with asthma significantly reduced the
risk for an exacerbation. In trials of LTRA monotherapy, LTRAs
significantly improved asthma control compared with placebo, whereas
only some measures of asthma control were significantly improved in
trials of LTRAs used as add-on use therapy to ICSs.
Medical Research: What should clinicians and patients take away from your report?
Dr. Miligkos: Our findings suggest that leukotriene-receptor antagonists may be an efficacious and safe, either as an alternative treatment, in adult and adolescent patients who cannot or prefer not to take ICSs or as add-on treatment, in patients
with concomitant ICS use. However, which patients are more likely to
respond to LTRAs remains unclear. Therefore, primary care physicians
may identify patients with specific disease characteristics (asthma
phenotypes) who may respond well to LTRAs (such as patients with mild
asthma and concurrent allergic rhinitis) and provide them with all the
available evidence to make an informed decision for their therapy.
Nevertheless, physicians should closely assess and monitor asthma
control and adjust the treatment regimen if needed.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Miligkos: Because not all patients respond well to inhaled
corticosteroids, the need for alternative treatments that would benefit specific subpopulations increases. Therefore, professional organizations or expert panels
should recommend standardized study- protocols, definitions of
phenotypes, and outcome measures (e.g.,such as asthma control test,
and asthma control questionnaire) for the purpose of research and
encourage future researchers to implement these standards.
Citation:
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Michael Miligkos, MD, MS (2015). Study Evaluates Non-Steroidal LTRAs For Asthma
Last Updated on November 16, 2015 by Marie Benz MD FAAD