Which drug is the controller medication of choice for children and adults in the treatment of asthma?

Updated: Nov 20, 2020
  • Author: Michael J Morris, MD, FACP, FCCP; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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A study by Price et al randomly assigned patients to 2 years of open-label therapy with leukotriene antagonists (148 patients) or an inhaled glucocorticoid (158 patients) in the first-line controller therapy trial and a leukotriene antagonist (170 patients) or long-acting beta-agonists (182 patients) added to an inhaled glucocorticoid in the add-on therapy trial. [71] The results of these two trials suggests that a leukotriene antagonist is equivalent to both comparison drugs with regard to asthma-related quality of life at 2 months, but equivalence was not proven at 2 years.

A Cochrane review found that inhaled corticosteroids are superior to anti-leukotrienes when used as monotherapy in adults and children with persistent asthma. The superiority of inhaled corticosteroids is most pronounced in asthma patients with moderate airway obstruction. [72] The 2019 Global Initiative for Asthma (GINA) guidelines identify inhaled corticosteroids as the preferred controller medication of choice for children and adults.

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