The Cochrane Library and Leukotriene Receptor Antagonists for Children with Asthma: An Overview of Reviews

Background Asthma is a common childhood disease characterised by chronic inflammation of the airways. One treatment option is the class of medications known as the leukotriene receptor antagonists (LTRAs). The use of LTRA in combination with inhaled corticosteroid (ICS) may improve asthma control by...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Evidence-based child health 2008-09, Vol.3 (3), p.595-602
Hauptverfasser: Bjornson, Candice L., Russell, Kelly, Plint, Amy, Rowe, Brian H.
Format: Artikel
Sprache:eng
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
Beschreibung
Zusammenfassung:Background Asthma is a common childhood disease characterised by chronic inflammation of the airways. One treatment option is the class of medications known as the leukotriene receptor antagonists (LTRAs). The use of LTRA in combination with inhaled corticosteroid (ICS) may improve asthma control by reducing mucus secretion, inflammation and bronchoconstriction via this alternate pathway. Objectives To synthesise the evidence currently in The Cochrane Library Database Of Systematic Reviews (CDSR) related to the question, ‘In children with symptomatic but stable asthma, does treatment with a LTRA as a primary or add‐on therapy to ICS improve objective measures of lung function and asthma symptom control, reduce exacerbations, and improve quality of life compared to standard care?’ Methods CDSR was searched using the term ‘asthma’ in the title for all systematic reviews examining anti‐leukotriene agents vs any other pharmacological agent for the treatment of asthma. Data were extracted and entered into tables; data were synthesised using qualitative and quantitative methods. Main Results Three reviews were identified; however, only two reviews contained data in children. There was no significant difference in change in FEV1, number of missed school days, or the proportion of children requiring oral corticosteroid treatment, or proportion of children who experienced an asthma exacerbation requiring hospital admission among those randomised to LTRA vs ICS. The addition of LTRA treatment to ICS resulted in no significant difference in the change in FEV1 or morning PEFR, use of β2‐agonist rescue medication, proportion of children admitted to the hospital due to an asthma exacerbation, or quality of life. Authors' Conclusions Until further evidence is available for children, LTRAs should not be substituted for ICS as monotherapy and ICS should remain the first line therapy for children with asthma. Currently, there is insufficient evidence to conclude that anti‐leukotriene agents added to ICS therapy improves asthma control, steroid‐sparing effect, or improved quality of life. Future research should address the gaps in children, including those as young as 2 years of age. Copyright © 2008 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. The Cochrane Collaboration
ISSN:1557-6272
1557-6272
DOI:10.1002/ebch.245