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Second-Line Care: Montelukast Finding Its Place in Asthma Therapy

KEY POINT

The leukotriene modifiers had just become available in the United States when NIH released its most recent set of guidelines for treatment of asthma. As researchers and clinicians continue defining the optimal use of these agents, two studies were recently published that support the basic precepts in the NIH guidelines: inhaled corticosteroids are the most effective first-line therapy for persistent asthma, while leukotriene modifiers are alternatives to inhaled corticosteroids as monotherapy. In addition, leukotriene modifiers may be beneficial for some patients when used in combination with inhaled cortico-steroids.

SOURCES

Busse W et al. Low-dose fluticasone propionate compared with montelukast for first-line treatment of persistent asthma: a randomized trial. J Allergy Clin Immunol. 2001;107:461–8.

Wilson AM et al. Evaluation of salmeterol or montelukast as second-line therapy for asthma not controlled with inhaled corticosteroids. Chest. 2001;119:1021–6.