Canadian respiratory journal : journal of the Canadian Thoracic Society
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In children with persistent asthma, inhaled glucocorticoids decrease symptoms and exacerbations, decrease the need for rescue bronchodilator medications, improve airway patency and reduce airway hyperresponsiveness. When administered in the lowest doses that prevent symptoms and eliminate the need for supplemental courses of oral glucocorticoids, they are unlikely to cause clinically important systemic adverse events. Inhaled glucocorticoids have a favourable risk to benefit ratio in this population.
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Review Comparative Study
Leukotriene receptor antagonists and related compounds.
Leukotrienes (LTs), lipid mediators of inflammation, have proved to be important biochemicals involved in the symptoms and physiological changes of asthma. In the past year and a half, the development of three new drugs that modulate the LT pathway has been completed. The first subclass of these drugs, leukotriene receptor antagonists (LTRA) (zafirlukast and montelukast), blocks the interaction of the cysteinyl form of the LTs with the cell type bearing the receptor. ⋯ Comparison studies with low doses of inhaled corticosteroids suggest that LT modulators may have similar effects on symptom scores and beta-agonist use, but have lesser effects on FEV1. Finally, emerging data suggest that these drugs are beneficial in decreasing the dose of inhaled corticosteroids necessary to control more moderate to severe asthma. While long term studies will be helpful in determining the 'disease modifying' effects of these drugs, data suggest that these drugs are useful in the treatment of a broad range of asthmatic patients.