Asthma drug may improve control, reduce risk of exacerbations
Despite the results, the authors noted that which patients are more likely to respond to LTRAs remains unclear.
Leukotriene-receptor antagonist (LTRA) tablets may significantly improve asthma control and reduce the risk for an exacerbation in adults and adolescents when compared to placebo, but which patients are most likely to respond to treatment remains unclear, a review found.
To determine the benefits and harms of LTRAs as monotherapy or in combination with inhaled corticosteroids, researchers reviewed the peer-reviewed literature through June 2015. Results appeared online Sept. 22 in Annals of Internal Medicine.
The authors found that LTRAs significantly reduced the risk for an exacerbation in trials where they were used as monotherapy. Of the 50 trials that met eligibility criteria, random-effects meta-analyses (a method that weights the average of the effect sizes) of 6 trials in which the definition of an exacerbation was consistent with the researchers' definition (1,703 patients who received an LTRA and 1,124 patients who received placebo) showed LTRAs were associated with a risk ratio (RR) of 0.60 for an exacerbation (95% CI, 0.44 to 0.81). In 4 trials of LTRAs as add-on therapy to inhaled corticosteroids, the summary RR for exacerbation was 0.80 (95% CI, 0.60 to 1.07) compared to placebo patients.
Adverse event rates were similar in the intervention and comparator groups, the authors noted. The proportions of patients with adverse events were generally similar in the intervention and comparator groups. Across all trials, no serious adverse events were reported, and withdrawals from adverse events or worsening asthma were generally similar across groups.
Despite the results, the authors noted that which patients are more likely to respond to LTRAs remains unclear. “Asthma is a complex disease with various clinical, inflammatory, and trigger-related phenotypes that may overlap,” they wrote. “It is hypothesized that proper identification of these phenotypes would lead to better disease management. Moreover, because not all patients respond well to [inhaled corticosteroids], the need for alternative treatments that would benefit specific subpopulations increases.”