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Jornal de Pediatria
On-line version ISSN 1678-4782
RIBEIRO, Jose Dirceu; TORO, Adyléia A. D. C. and BARACAT, Emilio C. E.. Antileukotrienes in the treatment of asthma and allergic rhinitis. J. Pediatr. (Rio J.) [online]. 2006, vol.82, n.5, suppl., pp. S213-S221. ISSN 1678-4782. http://dx.doi.org/10.1590/S0021-75572006000700012.
OBJECTIVE: To compare leukotriene antagonists (LTA) to other groups of drugs used in asthma and allergic rhinitis treatment. SOURCES: MEDLINE, LILACS and Cochrane Library. Keywords: leukotrienes, antileukotrienes, asthma treatment, allergic rhinitis treatment, asthma and allergic rhinitis. An attempt was made to group the main studies and reviews about this topic. SUMMARY OF THE FINDINGS: LTA are more efficient than placebo and enhance the effects of inhaled corticosteroids. The association of inhaled corticosteroids with long-acting b2-agonists is more efficient than the association of inhaled corticosteroids + LTA. Although use of LTA in acute asthma attacks and allergic rhinitis seems reasonable, more studies are needed to confirm this benefit. LTA reduce hospitalization time and the number of wheezing attacks in infants with acute viral bronchiolitis caused by respiratory syncytial virus, as well as recurrent wheezing after acute viral bronchiolitis. LTA are less efficient than intranasal corticosteroids for allergic rhinitis management. LTA are efficient in exercise-induced asthma, although they are not the first-line treatment. CONCLUSIONS: Controlled and randomized studies show that inhaled corticosteroids are the drugs of choice to treat persistent asthma and allergic rhinitis. There is not enough evidence to recommend the use of LTA as first-line drug (monotherapy) in children with asthma (level I). For children who cannot use inhaled corticosteroids, LTA may be a good alternative (level II).
Keywords : Asthma; exercise-induced asthma; rhinitis; antileukotrienes; montelukast; zafirlukast.