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The National Asthma Education and Prevention Program Guidelines recommend inhaled corticosteroids (ICS) as first-line therapy for patients with persistent asthma and leukotriene-receptor antagonists (LTRAs) as an alternative therapy. They state that patients whose asthma is not controlled by low-dose ICS should add a long-acting β-agonist or should double the ICS dose; again, adding an LTRA is an alternative. Although many LTRA trials for asthma have been performed, a large meta-analysis of their effectiveness compared with placebo has not.
To assess the effectiveness of LTRAs as monotherapy or add-on therapy versus placebo, researchers included 50 trials (9872 adult and pediatric patients) in a systematic review and 34 trials in meta-analys…