Leukotriene-receptor antagonists may be as effective as inhaled corticosteroids for first-line treatment of asthma and as effective as long-acting beta agonists for add-on therapy, according to two "real-world" trials reported in the New England Journal of Medicine.
The two trials included individuals aged 12 years and older with asthma. In one, some 300 patients beginning asthma therapy were randomized to open-label treatment with either a leukotriene antagonist or an inhaled glucocorticoid. In the other, roughly 350 patients already taking an inhaled glucocorticoid were randomized to add-on therapy with a leukotriene antagonist or a long-acting beta agonist.
The primary endpoint — asthma-related quality of life at 2 months — was similar between treatment groups. However, the researchers report that at 2 years, outcomes did not quite meet equivalence criteria.
Editorialists note that leukotriene antagonists likely work well in real-world settings because of their ease of use (i.e., pill vs. inhaler).
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