ABSTRACT
The optimal management of asthma involves control of symptoms, pre-
vention of variable obstruction to airflow, decrease of bronchial hyperresponsiveness, and reversal of the underlying inflammation involved in its
pathogenesis. The ideal asthma therapy has a rational scientific basis, is ef-
fective in decreasing symptoms and maintaining lung function, is safe, is easy
to administer, and meets the expectations of patients who take the drug. Over
the last decade, leukotriene modifiers have emerged as one of the few new
therapeutic options for asthma that meets each of these criteria. Leukotri-
enemodifiers include both cysteinyl leukotriene receptor antagonists (such as
zafirlukast, montelukast, and pranlukast) and 5-lipoxygenase (5-LO) inhibitors (such as zileuton). They are the first asthma therapies to evolve from our
understanding of the pathophysiology of the disease: They specifically target
a pathway of pathogenesis, rather than nonspecifically mediating inflamma-
tion and controlling symptoms. In this chapter, we discuss the attributes of
these medications that make them an excellent therapy for asthma and the
roles of these agents in the context of other asthma treatment modalities.
