Leukotriene receptor antagonist (LTRA) pills are just as effective as inhalers in managing asthma symptoms, and are much easier to use, researchers from the University of East Anglia, England reported in NEJM (New England Journal of Medicine).

LTRAs are infrequently prescribed as an alternative to inhalers because some people believed them to be less effective. This latest study shows they are effective.

Examples of LTRAs include Singulair (montelukast) and Accolate (zafirlukast). In the United Kingdom guidelines recommend LTRAs as a third step in asthma management.

Prof David Price and team monitored 650 asthma patients for 24 months. There was clear evidence that LTRAs are not only just as effective as inhalers, they are also much more user-friendly.

The researchers explain that LTRAs are an effective alternative to steroid inhalers and other preventer inhalers which are used alongside steroid inhalers. They say these tablets could be used by over four-fifths of patients who have difficulties with inhalers, cannot use them because of the side-effects, or want to avoid taking steroids.

Lead author Prof David Price, said:

“We hope these findings will increase the options for healthcare professionals when prescribing for this common but disruptive disease. We found that adherence to treatment was vastly improved – by as much as 60 per cent – when patients were given the once-a-day LTRA tablets and patients did not have to worry about using appropriate inhaler technique.”

Co-author Dr Stanley Musgrave wrote:

“LTRAs are easy to use and can help patients control their asthma effectively and improve their quality of life.”

The randomized controlled study, called ELEVATE, designed by researchers from the University of Aberdeen, Scotland and the University of East Anglia, aimed to evaluate asthma treatments in a real-world setting.

The 650 participants came from GP practices in England – Norfolk, Dorset, Hampshire, Cambridgeshire, Essex and Suffolk. The National Health Service’s Health Technology Assessment program financed the trial.

Asthma rates are increasing in the UK and the rest of the world. There are now 4.3 million more people with asthma in the USA than eight years ago. It is a long-term (chronic), incurable condition in which the airways become inflamed (swollen), they narrow as a result and less air can come into and out of the lungs. Asthma can have a serious impact on a patient’s quality of life. Patients experience coughing, wheezing, chest tightness, and shortness of breath.

“Leukotriene antagonists as a first-line or add-on asthma controller therapy”
D Price, S Musgrave, L Shepstone, E Hillyer (Research in Real Life), E Sims, R Gilbert, E Juniper, J Ayres, L Kemp, A Blyth, E Wilson, S Wolfe, D Freeman, M Mugford
New England Journal of Medicine, May 5 2011.

Written by Christian Nordqvist