Inhaled Corticosteroid and Leukotriene Receptor Antagonist Combination Therapy

The combination of inhaled corticosteroids (ICS) and leukotriene receptor antagonists (LTRA) represents a therapeutic approach for asthma management. This combination leverages complementary mechanisms of action to control asthma symptoms and inflammation. Inhaled corticosteroids are considered the most effective long-term medication for control and management of asthma, providing broad anti-inflammatory effects in the airways[4]. However, they do not suppress the inflammatory effects of cysteinyl leukotrienes[6]. Leukotriene receptor antagonists work by blocking the cysteinyl leukotriene 1 receptor, preventing leukotrienes (LTC4, LTD4, and LTE4) from binding to these receptors[5][6]. This inhibits physiological actions of leukotrienes that contribute to asthma symptoms, including bronchoconstriction, increased vascular permeability, and mucus production[7]. The combination therapy is typically used as an add-on treatment when asthma symptoms remain uncontrolled despite medium-dose inhaled corticosteroids[7]. It may be particularly beneficial for patients with night-time symptoms, nasal symptoms (rhinitis), hay fever, or exercise-induced asthma[7].