Value of antagonists of inflammatory mediators in the treatment of asthma.

Leukotrienes participate in inflammation of the airways observed in asthmatic patients and therefore constitute a preferential target for the therapeutic management of these patients. Although inhaled corticosteroids are currently the cornerstone of the treatment of asthma, they are probably not devoid of systemic effects at high doses (greater than 1 000 mu g) and during prolonged use, especially in mild to moderate asthma. Anti-inflammatory treatment is recommended from the stage of mild persistent asthma (stage 2 of the latest international recommendations) and obviously in more severe stages. The objective of this review article is to define the potential place of leukotriene inhibitors in the various stages of severity of asthma, whenever anti-inflammatory treatment is considered. Compared to other inhaled corticosteroids, an oral form, as is the case for many leukotriene inhibitors, can help to improve compliance. This therapeutic category can also be recommended in patients with mild to moderate asthma or severe asthma, in which it may allow a reduction of the doses of inhaled corticosteroid.