EDITORIALS
Leukotriene receptor antagonist therapy and Churg–Strauss syndrome: culprit or innocent bystander?
1 Medical Research Institute of New Zealand, Wellington, New Zealand
2 University of Otago Wellington, Wellington, New Zealand
Correspondence to:
Professor Richard Beasley, Medical Research Institute of New Zealand, PO Box 10055, Wellington 6143, New Zealand; Richard.Beasley@mrinz.ac.nz
| The first 150 words of the full text of this article appear below. |
Randomised controlled trials can provide strong evidence of the efficacy (or lack) of new drug treatments as well as the occurrence of common side effects.1 However, clinical safety issues can arise after new medications receive regulatory approval, particularly in relation to rare serious adverse events.2 Investigation of rare adverse events is often fraught with difficulty, leading to uncertainty, particularly when there is conflicting evidence from research utilising different methodologies. One recent example is the observed association between leukotriene receptor antagonist (LTRA) therapy, used in the treatment of asthma, and Churg–Strauss syndrome (CSS), a vasculitis of uncertain aetiology (also known as allergic granulomatous angiitis). CSS is certainly both rare and serious, with a background incidence of 3 per million per year in the general population, and a 1 year mortality rate of 7%.3–5
Soon after the introduction of LTRAs (zafirlukast, pranlukast and montelukast), numerous case reports and case series were published
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