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2-6 EFFECTIVENESS OF THE
LEUKOTRIENE-RECEPTOR ANTAGONIST ZAFIRLUKAST FOR MILD-TO
MODERATE ASTHMA
A daily regimen of zafirlukast added to as-needed inhaled
beta-agonists is more effective than beta-agonists alone
in treating mild to moderate asthma.
The clinical and economic effectiveness of zafirlukast, a
potential alternative to inhaled corticosteroids,
provides further impetus to use regular preventive
therapy. Annals Int. Med. February 1, 1997; 126: 177-83 2-6 EFFECTIVENESS OF THE
LEUKOTRIENE-RECEPTOR ANTAGONIST ZAFIRLUKAST FOR MILD-TO
MODERATE ASTHMA
Leukotrienes are implicated in broncho-constriction and
formation of airway edema in patients with asthma.
Antagonists to leukotrienes must be shown to be both
clinically and economically effective for their use to be
justified.
This study assessed the clinical and economic
effectiveness of zafirlukast (Accolate ) in patients with
mild-to-moderate asthma who might benefit from regular
anti-inflammatory therapy.
Conclusion: Zafirlukast was effective treatment.
STUDY
- Randomized,
double-blind, placebo-controlled trial entered
146 outpatients (age 12 and over—mean
32).with mild-to-moderate asthma
- All had a FEV1 of at
least 55% of predicted with no upper limit. All
had demonstrated bronchial hyper-responsiveness
and were symptomatic within the preceding week.
- Randomized to: 1)
zafirlukast 20 mg twice daily plus inhaled
beta-agonist (albuterol) as needed, or 2) placebo
plus inhaled beta-agonists as needed. Zafirlukast
is taken orally and must be taken daily.
- No other medications
for asthma were permitted.
- Follow-up—3
months.
RESULTS
Zafirlukast group had more days without symptoms (7 days
vs 4 days per month); more days without use of
beta-agonists (11 vs 6 days per month): and more days
without episodes of asthma (10 vs 5 days per month); 55%
fewer health care contacts (19 per 100 patients per month
vs 41); fewer days of absence from work or school (16 vs
35 per 100 patients per month). They used fewer canisters
of inhaled beta-agonists. (47 vs 57 per 100 patients per
month).
DISCUSSION
- Daily use of
zafirlukast combined with beta-agonist was more
effective than beta-agonist alone in treatment of
mild-to-moderate asthma.
- Zafirlukast led to
significantly more days without symptoms, without
beta-agonists, and without episodes of asthma.
- In addition, it
significantly affected economic outcomes,
reducing both the use of health services and rate
of absenteeism.
CONCLUSION
A daily regimen of zafirlukast added to as-needed inhaled
beta-agonists is more effective than beta-agonists alone
in treating mild to moderate asthma.
The clinical and economic effectiveness of zafirlukast, a
potential alternative to inhaled corticosteroids,
provides further impetus to use regular preventive
therapy.
Annals Int. Med. February 1, 1997; 126: 177-83
Original study, first author from Royal Victoria
Hospital, Quebec, Canada
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