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    Asthma Treatment: Steroids and Other Anti-Inflammatory Drugs

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    How Do the Leukotriene Modifiers Improve Asthma Control?

    Montelukast (Singulair), zafirlukast (Accolate), and zileuton (Zyflo) are called leukotriene modifiers. Leukotrienes are inflammatory chemicals that occur naturally in our bodies and cause tightening of airway muscles and production of mucus. Leukotriene modifier drugs help control asthma by blocking the actions of leukotrienes in the body. Studies show that these medications are helpful in improving airflow and reducing asthma symptoms.

    The leukotriene modifiers are taken as pills and have been shown to decrease the need for other asthma medications. These medications have also been shown to be effective in people with allergic rhinitis (nasal allergies) and may be effective in people with both allergic rhinitis and allergic asthma.

     

    What Are the Side Effects of Leukotriene Modifiers?

    The most common side effects of leukotriene modifiers are headache, nausea, vomiting, insomnia, and irritability. Leukotriene modifiers may interfere with other medications (for example, theophylline and the blood thinnerwarfarin). Make sure you inform your doctor of all the medications you are taking.

    How Do Immunomodulators Work to Improve Asthma Control?

    Mepolizumab (Nucala) is the first biologic therapy that has been found to control the blood cells that often trigger asthma. Nucala targets Interluken-5 (IL-5) which regulates the levels of blood eosinophils (the type of white blood cells that helps trigger asthma). Genetically engineered, Nucala keeps IL-5 from binding to eosinophis and thereby lowers the risk of a severe asthma attack.

    Nucala is administered by injection once every 4 weeks and is meant to be used in conjunction with other asthma treatments. By using Nucala, patients have been found to not only experience fewer asthma incidents, but they are able to reduce the amount of their other asthma medications.

    Omalizumab (Xolair), an immunomodulator, works differently from other anti-inflammatory medications for asthma. Xolair blocks the activity of IgE (a protein that is overproduced in people with allergies) before it can lead to asthma attacks. Immunomodulator treatment has been shown to help reduce the number of asthma attacks in people with moderate to severe allergic asthma whose symptoms are not controlled with inhaled steroids.

    Xolair, a prescription medication, is given by injection every 2 to 4 weeks. It's recommended for people with moderate to severe allergic asthma. Side effects may include redness, pain, swelling, bruising or itching at the injection site, joint pain, and tiredness. There is a slight increase in risk for problems with the heart and circulation to the brain in people using Xolair. It also carries a boxed warning about a severe, potentially life-threatening allergic reaction (anaphylaxis).

    WebMD Medical Reference

    Reviewed by Jennifer Robinson, MD on January 10, 2016
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