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Review: adding antileucotrienes to inhaled corticosteroids reduces exacerbations in symptomatic chronic asthma

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 QUESTION: In patients with chronic asthma, how effective and safe is daily antileucotriene (AL) treatment plus inhaled corticosteroids (ICS) compared with ICS alone?

Data sources

Studies were identified by searching 4 electronic databases up to September 2001; scanning the reference lists of articles and reviews; reviewing meeting abstracts (1998 to 2000); and contacting the international headquarters of AL manufacturers.

Study selection

Studies were selected if they were randomised controlled trials evaluating the effectiveness of AL for ≥ 1 month in patients with asthma who were ≥ 2 years of age.

Data extraction

Data were extracted independently by 2 reviewers on study quality, patient characteristics, intervention type and duration, and main outcome measures.

Main results

13 trials (12 in adults and 1 in children) were included. Combining data from 2 of the 6 trials in symptomatic patients and after 4 to 16 weeks of treatment showed that the addition of higher-than-licensed AL doses to ICS reduced the risk for exacerbations requiring systemic corticosteroids (table). The addition of …

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  • Source of funding: in part, Canadian Cochrane Network.

  • For correspondence: Dr F M Ducharme, McGill University, Montreal, Quebec, Canada. Francine.ducharme{at}