Antileukotriene drugs in the treatment of asthma

Abstract

Antileukotriene medications that have been implemented into clinical practice of bronchial asthma and allergic rhinitis include specific leukotriene receptor antagonists (montelukast, zafirlukast, pranlukast) and leukotriene biosynthesis inhibitors (zileuton). The current GINA (Global Initiative for Asthma) guidelines, the PRACTALL (Practicing Allergology) report on asthma treatment in children, and ARIA (Allergic Rhinitis and its Impact on Asthma) recommendations classify antileukotriene therapeutic agents as a group of drugs controlling the course of the disease. However, inhaled glucocorticosteroids still remain the first-line treatment in chronic asthma. According to current guidelines, antileukotriene drugs are recommended as alternative treatment to low-dose inhaled glucocorticosteroids in the second level of asthma severity and as complementary treatment to inhaled and/or oral glucocorticosteroids, starting from the third level of asthma severity. Recently, clinical efficacy of antileukotriene drugs has been suggested in the treatment of isolated allergic rhinitis, chronic cough in the course of asthma, as a sole symptom of the disease, and as the therapy for episodes of wheezing caused by viral infections.