- The Cysteinyl-leukotrienes are potent bronchoconstrictors derived mainly from mast cells mediators and are part of the inflammatory and bronchial constriction that occurs during asthma.
- Leukotriene receptor antagonists (LTRA) or Leukotriene modifiers are being used as an adjunct therapy to ICS (Inhaled Corticosteroids)
- There are 3 available
- Montelukast
- Zafirlukast
- Zileuton
- They are not considered a first line controller agent
- In clinical trials, ICS are favored over the use of LTRA
- Leukotriene modifiers have not been used in episodes of acute exacerbation of asthma but some research has been done:
- A multicenter trial evaluated 641 acute asthmatics patients receiving a oral dose of zafirlukast
- They found;
- Improvement of dyspnea
- Increased FEV1
- decreased risk of relapse
- decreased risk of extended hospital care
- Research has also looked at intravenous leukotreine modifiers in the acute setting
- 201 patients showed improvement in FEV1 in the 20 minutes post treatment [11]
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