Leukotriene antagonists and the Churg-Strauss syndrome

Ghassan Jamaleddine, Karim Diab, Zuhayr Tabbarah, Ayman Tawil, Thurayya Arayssi

Research output: Contribution to journalArticle

47 Citations (Scopus)

Abstract

Background and Objectives: Leukotriene antagonists (LTAs), or antileukotrienes, are a new group of anti-inflammatory drugs used for the treatment of asthma. They might substitute for or allow tapering of corticosteroids in asthmatic patients. These drugs have been associated with the development of Churg-Strauss syndrome (CSS), a rare form of vasculitic angiitis. It is unclear whether the development of CSS is a direct drug effect or an unmasking of a preexisting condition on withdrawal of steroids for asthma. We present a case of CSS in a patient treated with montelukast and review the literature to analyze the association between LTAs and the development of CSS. Method: We reviewed the literature using MEDLINE from February 1966 to October 2000. To the cases identified, we present an additional case of a patient who underwent a diagnostic lung biopsy. Results: Twenty-two case reports of patients receiving LTAs who developed CSS were identified. The onset of CSS occurred 2 days to 10 months after starting treatment with LTAs. All patients had received inhaled or oral steroids for asthma. The interval between the last oral corticosteroid treatment and CSS onset ranged from 3 days to 8 months. Conclusions: To date, there is no compelling evidence that the development of CSS in asthmatic patients receiving LTAs results from a direct drug effect. Rather, it appears that tapering of corticosteroids in these patients unmasks the multiorgan manifestations of the disease. We believe that the use of LTAs should not be influenced by the apparent increase in the incidence of CSS and that these are still safe drugs for asthma.

Original languageEnglish
Pages (from-to)218-227
Number of pages10
JournalSeminars in Arthritis and Rheumatism
Volume31
Issue number4
DOIs
Publication statusPublished - 2002
Externally publishedYes

Fingerprint

Churg-Strauss Syndrome
Leukotriene Antagonists
Asthma
Adrenal Cortex Hormones
Pharmaceutical Preparations
montelukast
Steroids
Preexisting Condition Coverage
Vasculitis
MEDLINE
Anti-Inflammatory Agents
Therapeutics
Biopsy
Lung

Keywords

  • Asthma
  • Churg-Strauss syndrome
  • Corticosteroids
  • Leukotriene antagonists

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Orthopedics and Sports Medicine
  • Rheumatology

Cite this

Leukotriene antagonists and the Churg-Strauss syndrome. / Jamaleddine, Ghassan; Diab, Karim; Tabbarah, Zuhayr; Tawil, Ayman; Arayssi, Thurayya.

In: Seminars in Arthritis and Rheumatism, Vol. 31, No. 4, 2002, p. 218-227.

Research output: Contribution to journalArticle

Jamaleddine, Ghassan ; Diab, Karim ; Tabbarah, Zuhayr ; Tawil, Ayman ; Arayssi, Thurayya. / Leukotriene antagonists and the Churg-Strauss syndrome. In: Seminars in Arthritis and Rheumatism. 2002 ; Vol. 31, No. 4. pp. 218-227.
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