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LRTAs ‘should be alternative second-line asthma treatment’



By Nigel Praities

UK researchers have questioned current asthma guidelines by suggesting leukotriene receptor antagonists should be promoted to be an alternative second-line treatment.

This new analysis looked at nearly 400 patients aged 12 to 80 years in primary care whose asthma was not controlled on inhaled corticosteroids alone. They randomised patients to either a long-acting beta agonists or a LTRA.

They found the LTRAs had a higher ‘societal cost’ – £1,157 compared with £952 for LABA treatment – over two years and were only associated with a small, non-significant gain of 0.009 quality-adjusted life years, compared to a LABA. But the LTRA was still judged cost-effective, with a cost per QALY of £22,589.

Current NICE and BTS-SIGN guidance on asthma list LTRAs as an alternative add-on treatment to inhaled corticosteroids, once LABA have been tried.

But lead author Mr Edward Wilson, a research associate lecturer in health economics at the University of East Anglia, concluded there may be a place for the treatments as an alternative to LABA.

‘These results marginally favour the repositioning of LTRAs as a cost-effective alternative to LABA as an add-on therapy to ICS for asthma.’

Pharmacoeconomics 2010, online May 6

UK researchers have questioned current asthma guidelines by suggesting leukotriene receptor antagonists should be promoted to be an alternative second-line treatment UK researchers have questioned current asthma guidelines by suggesting leukotriene receptor antagonists should be promoted to be an alternative second-line treatment