Leukotriene Inhibition and Advances in the Treatment of Asthma: A Pharmacological Review

The optimal treatment of asthma remains problematic when considered by healthcare providers. Despite increasing knowledge regarding the pathophysiology of asthma and the role of inflammatory mediators, prevalence as well as morbidity and mortality rates continue to rise. Since the introduction of inhaled β-agonists and inhaled corticosteroids in the 1980s, little has changed in the pharmacological armamentarium of treatment options. Recently, attention has focused on the pharmacological manipulation of leukotrienes as treatment modalities. Two leukotriene modifiers introduced in 1996 herald the first new pharmacological class of antiasthma medicines in the United States in 25 years. With the significant morbidity and mortality of asthma as well as cost in healthcare dollars and time lost from work, attention to these agents and their role in the treatment of asthma is warranted. The objective of this article is to review the pharmacology and clinical applications of this new class of drugs focusing specifically on the two recently introduced agents, zafirlukast and zileuton. Historical perspectives in the treatment of asthma and potential, future uses of leukotriene modifiers is also addressed.