Antileukotrienes. A new pharmacological class in asthma therapy

A new class of drugs, leucotriene receptor antagonists and leukotriene syntesis inhibitors - antileukotrienes -, has been recently studied and tested in vitro and in vivo and showed an interesting effect in the control of asthma. Asthma is a chronic disease and should be treated with both controller and reliever drugs. Low compliance with the available inhaled therapy is one of the causes of a not completely satisfactory treatment of asthma. Two antileukotrienes, zafirlukast and montelukast, are now available in Italy, both cysteinyl leukotrienes receptor antagonist. They improve symptoms and inhibit some of inflammatory mediators of asthma. Their oral administration route (respectively twice and once a day) is related to a best compliance to treatment of asthma. Adverse events related to administration are rare and the possible role in substituting part of the steroid treatment helps in decreasing steroid-related adverse effects. In this review we will focus on the present limits of asthma therapy, on history and biochemistry of antileukotrienes, on their pharmacological development and their particular usefulness in seasonal allergic, exercise-induced, nocturnal and aspirin-induced asthma, on their interesting perspectives in rhinitis associated to asthma and finally on their impact in social costs. The aim is to have a better knowledge on a new tool to use in the treatment of mild to severe persistent asthma according to OMS guide-lines.