Leukotriene receptor antagonists in asthma therapy

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Presentation transcript:

Leukotriene receptor antagonists in asthma therapy Stephen P. Peters, MD, PhD Journal of Allergy and Clinical Immunology Volume 111, Issue 1, Pages S62-S70 (January 2003) DOI: 10.1067/mai.2003.21 Copyright © 2003 Mosby, Inc. Terms and Conditions

Fig. 1 Effects of the LTRA zafirlukast (black bars, n = 514) and placebo (white bars, n = 248) on asthma symptoms, β-agonist use, and pulmonary function in patients with mild-to-moderate asthma. Baseline asthma characteristics were similar between groups, except for nighttime awakenings, which occurred significantly less often (P = .02) in the placebo group. FEV1 was 78% of predicted. AM-PEF, Morning PEFR. Data from Fish JE, Kemp JP, Lockey RF, Glass M, Hanby LA, Bonuccelli CM. Zafirlukast for symptomatic mild-to-moderate asthma: a 13-week multicenter study. The Zafirlukast Trialists Group. Clin Ther 1997;19:675-90. Journal of Allergy and Clinical Immunology 2003 111, S62-S70DOI: (10.1067/mai.2003.21) Copyright © 2003 Mosby, Inc. Terms and Conditions

Fig. 2 Distribution of treatment responses for FEV1. In a study comparing beclomethasone with montelukast in 895 adults with persistent asthma, the distributions of discrete FEV1 response for both groups were represented by bell-shaped curves, with about 50% of the beclomethasone group (white bars, n = 246) and 42% of the montelukast group (black bars, n = 375) showing improvement of at least 11% in FEV1. Adapted from Malmstrom K, Rodriguez-Gomez G, Guerra J, Villaran C, Pineiro A, Wei LX, et al. Oral montelukast, inhaled beclomethasone, and placebo for chronic asthma: a randomized, controlled trial. Montelukast/Beclomethasone Study Group. Ann Intern Med 1999;130:487-95. Journal of Allergy and Clinical Immunology 2003 111, S62-S70DOI: (10.1067/mai.2003.21) Copyright © 2003 Mosby, Inc. Terms and Conditions

Fig. 3 Effect of sleep on airway-parenchymal interdependence in patients with nocturnal asthma. Black circles represent the lower airway resistance (Rlp) and thoracic gas volume during early (approximately 0.5 hours) and late (approximately 2.5 hours) sleep at baseline. White circles represent data obtained when the thoracic gas volume (TGV) was increased by approximately 1 L with negative extrathoracic pressure. In both situations, increasing the thoracic gas volume did not decrease airway resistance, suggesting a loss of airway-parenchymal coupling. With increasing sleep time, there was an additional increase in lower airway resistance, which occurred when increased markers of inflammation have been shown to be present in patients with nocturnal asthma. Data points are ± SEM. Adapted from Irvin CG, Pak J, Martin RJ. Airway-parenchyma uncoupling in nocturnal asthma. Am J Respir Crit Care Med 2000;161:50-6. Journal of Allergy and Clinical Immunology 2003 111, S62-S70DOI: (10.1067/mai.2003.21) Copyright © 2003 Mosby, Inc. Terms and Conditions