May 4, 2011 -- The drugs Singulair and Accolate proved to be just as effective as steroid inhalers for the prevention of asthma symptoms with better patient compliance in two new studies published in this week’s New England Journal of Medicine.
Both drugs are leukotriene receptor antagonists (LTRAs) and both were approved more than a decade ago as alternatives to “preventer” inhalers. But they are not as widely used and some studies have found them to be less effective for asthma control in patients with mild persistent asthma.
The new studies were conducted in the U.K. In one, patients with chronic asthma were treated daily with an LTRA or an inhaled steroid to prevent asthma attacks. In another an LTRA or an inhaled long-acting bronchodilator (LABA) was added to treatment with an inhaled steroid.
All the asthma patients continued to use short-acting “rescue” inhalers when needed to open constricted airways and help them breathe when asthma attacks occurred.
Unlike earlier studies, which excluded up to 95% of asthma patients for one reason or another, the only patients excluded from the two studies were those with terminal cancer or a diagnosis of chronic obstructive pulmonary disease (COPD), researcher Stanley Musgrave, MD, of the University of East Anglia in Norwich, U.K. tells WebMD.
“The drug licensing trials excluded the elderly, smokers, those who were depressed, diabetics and a long list of other conditions that people actually have,” he says. “The intent was to determine how well the drugs work in the best of circumstances, but that doesn’t necessarily tell you how real people do on particular treatments.”
Pills vs. Inhalers
In both trials, the LTRAs appeared to work as well as the inhaled treatments for preventing asthma symptoms over two years of follow-up, and in both trials, patients in the LTRA sections of the study proved to be more compliant with the treatments.
Rates of treatment adherence were 65% and 74% among patients who took the LTRA pills, compared to 41% and 46% among patients treated with the preventive inhaled steroids.