RESUMO
The world-wide prevalence of asthma is believed to be about 7 percent and about 100 million individuals are thought to suffer from this disorder. Asthma is becoming more common although living standards are improving. Fifty years ago, when the UWI Medical School was born, the medications used for asthma included the theophyllines and adrenaline like drugs. Over the years, more effective approaches to treatment which have become available include improved environmental control, more specific beta-agonist agents and relatively safe high dose inhaled steroids, and theophylline use has considerable decreased. Within the past few years, leukotriene receptor antagonists have been investigated in Europe and North America and they represent the first major new treatment for asthma in about 30 years. There is now substantial evidence that the leukotrienes play an important role in the pathophysiology of asthma and, by blocking their effects, these anti-leukotrienes have been shown to reduce airway obstruction, thereby producing acute and chronic improvement in pulmonary function, reducing asthma exacerbations and the need of rescue bronchodilators and steroids. A special group of asthmatic in whom anti-leukotrienes are particularly useful are the aspirin intolerant asthmatics, who may also have concurrent chronic sinusitis and nasal polyposis. These patients appear to have an over-production of leukotrienes and several studies have documented significant control of their asthma and improvement of their nasosinus disease with the use of these new agents. Zafirlukast (Accolate) was the first anti-leukotriene to become available in Canada about 6 months ago an another, montelukast, is due to be released shortly. These drugs are an important addition to the armamentarium for effective management of mild to moderate and moderate to severe persisting asthma.(AU)
