2017 Volume 31 Issue 3 Pages 313-325
Background : Inhaled corticosteroids (ICS) and leukotriene receptor antagonists (LTRA) are common drugs for chronic bronchial asthma control. The aim of this systematic review (SR) is to assess the efficacy of ICS compared with LTRA as monotherapy in children with asthma.
Methods : Randomized controlled trials (RCTs) were selected comparing efficacy of ICS with that of LTRA in children. The subjects were selected from previously published SRs of adults and children and RCTs published until March 2016. RCTs were searched from CENTRAL, MEDLINE, Embase, and the database of the Japan Medical Abstracts Society.
Results : Twenty RCTs were identified. Patients with ages 2 to 18 years were enrolled. The severity of asthma was classified as moderate-to-severe by the Japanese Pediatric Guidelines for the Treatment and Management of Asthma. We evaluated seven outcomes, including the number of patients who required at least one systemic corticosteroid administration for asthma exacerbation, number of patients who required hospital admission for asthma exacerbation, improvement in lung function, and adverse effects. The number of patients who required systemic corticosteroid administration for asthma exacerbation was significantly higher in the group treated with LTRA, compared with ICS treatment.
Conclusion : Patients over 2 years old with moderate-to-severe asthma treated with LTRA were more likely to develop asthma exacerbation and require systemic corticosteroids than those treated with ICS.
