Role of antileukotrienes in acute asthma exacerbations

Authors

  • Domenico Lorenzo Urso
  • Daniele Vincenzo Emergency Department, Vittorio Cosentino Hospital, Cariati M. (CS)
  • Lorenzo Formaro Emergency Department, Vittorio Cosentino Hospital, Cariati M. (CS)
  • Ada Federico Pharmacology Institute, Vittorio Cosentino Hospital, Cariati M. (CS)
  • Giuseppe Urso Doctor of Pharmacy, Cariati M. (CS)

DOI:

https://doi.org/10.7175/rhc.v3i2.155

Keywords:

Acute asthma, Antileukotrienes, Cysteinil-leukotrienes, Airways inflammation

Abstract

Acute asthma exacerbations are one of the most frequent reasons to visit the emergency department or general practitioner. Although current standard treatments for acute asthma – including supplemental oxygen, short-acting β2-agonists, systemic corticosteroids and anticholinergics – are quite effective in most patients, they are inadequate for rapid and sustained improvement in a significant proportion. The antileukotrienes, a relatively new class of drugs, have a role in the treatment of chronic asthma. Their relatively rapid onset of action after endovenous or oral administration and their additive effect to β2-agonists led to the hypothesis that they might be of benefit in acute asthma. This review examines the efficacy of antileukotrienes in the treatment of acute asthma.

References

Global Strategy for Asthma Management and Prevention, Global Initiative for Asthma (GINA) 2010. Available at: http://www.ginasthma.org (latest access March 2012). The Italian translation is available at: http://www.ginasthma.it

National Institutes of Health, National Heart, Lung and Blood Institute National Asthma Education and Prevention Program. Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma 2007; Publ. No. 08-4051

BTS, British Thoracic Society Scottish Intercollegiate Guidelines Network. British Guideline on the Management of Asthma. Thorax 2008; 63(Suppl IV): IV1-IV121

Sampson AP, Green CP, Spencer DG, et al. Leukotrienes in the blood and urine of children with acute asthma. Ann NY Acad Sci 1991; 629: 437-9

Hui KP, Barnes NC. Lung function improvement in asthma with a cysteinil-leukotriene receptor antagonist. Lancet 1991; 337: 1062-3

Foresi A, Paggiaro P. Inhaled corticosteroids and leukotriene modifiers in the acute treatment of asthma exacerbations. Curr Opin Pulm Med 2003; 9: 52-6

Peters-Golden M, Henderson WR. Leukotrienes. N Engl J Med 2007; 357: 1841-54

Montuschi P, Sala A, Dalhén SE, et al. Pharmacological modulation of the leukotriene pathway in allergic airway disease. Drug Discov Today 2007; 12: 404-12

Lynch KR, O’Neill GP, Liu Q, et al. Characterization of the human cysteinil leukotriene Cys-LT1 receptor. Nature 1999; 399: 789-93

Sampson AP, Pizzichini E, Bisgaard H. Effect of cysteinil leukotrienes and leukotriene receptor antagonists on markers of inflammation. J Allergy Clin Immunol 2003, 111: S49-59

Dalhén SE. Treatment of asthma with antileukotrienes: first line or last resort therapy? Eur J Pharmacol 2006: 533: 40-56

Montuschi P. Role of leukotrienes and leukotriene modifiers in asthma. Pharmaceutical 2010; 3: 1792-811; doi:10.3390/ph3061792

Urso DL. Treatment for acute asthma in the Emergency Department: practical aspects. Eur Rev Med Pharmacol Sci 2010; 14: 209-14

Strauss L, Hejal R, Galan G, et al. Observations on the effects of aerosolized albuterol in acute asthma. Am J Respir Crit Care Med 1997; 155: 454-8

Rowe BH, Spooner C, Ducharme FM, et al. Early emergency department treatment of acute asthma with systemic corticosteroids. Cochrane Database Syst Rev 2001; (1): CD002178

Dockhorn RJ, Baurngartner RA, Leff JA, et al. Comparation of the effects of intravenous and oral montelukast on airways function: a double blind, placebo controller, three period, crossover study in asthmatic patients. Thorax 2000; 55: 260-5

Camargo CA Jr, Smithline HA, Malice M, et al. A randomized controlled trial of intravenous montelukast in acute asthma. Am J Respir Crit Care Med 2003; 167: 528-33

Camargo CA Jr, Gurner DM, Smithline HA, et al. A randomized placebo-controlled study of intravenous montelukast for the treatment of acute asthma. J Allergy Clin Immunol 2010; 125: 374-80; doi:10.1016/j.jaci.2009.11.015

Silverman RA, Nowak RM, Korenblat PE, et al. Zafirlukast treatment for acute asthma. Chest 2004; 126: 1480-9; doi: 10.1378/chest.126.5.1480

Cylly A, Kara A, Ozdemir A, et al. Effects of oral montelukast on airway function in acute asthma. Respir Med 2003; 97: 533-6

Naqvi SH, Rukh M, Siddiqui FA et al. Role of leukotriene antagonist in acute severe attack of bronchial asthma in comparation with conventional therapy. Pak J Parmacol 2011; 28: 13-21

Kluitert LME, Watson D. Antileukotrienes as adjunctive therapy in acute asthma. Drug 2007; 67: 1665-70

Downloads

Published

2012-04-20

Issue

Section

Narrative reviews