2017 Volume 31 Issue 2 Pages 224-230
Aims : To evaluate the effectiveness of leukotriene receptor antagonist (LTRA) add-on therapy to inhaled corticosteroids in pediatric/adolescent patients with uncontrolled asthma.
Methods : A systematic review (SR) was performed for randomized controlled trials including patients aged 1-20 years. The primary endpoint of this SR was the number of patients with acute exacerbation requiring systemic corticosteroid during treatment.
Results : Three articles met the criteria for the SR. The recruitment age in all of the selected articles was>6 years old. ICS medications included budesonide 200-400μg/day or fluticasone propionate 200μg/day, and montelukast was used as an LTRA in the studies. There were no significant differences in the primary endpoint of asthma exacerbation (n=601, relative risk 0.93, 95% confidence interval 0.46-1.87).
Conclusion : LTRA add-on therapy in patients treated with ICS does not appear to prevent asthma exacerbations. Therefore, we do not uniformly recommend the use of LTRA as ICS add-on therapy. However, an LTRA add-on may be useful in younger children with infection-induced asthma exacerbations or in certain phenotypes of asthma.
