Asthma affects an estimated 235 million people globally, and as that number grows, so does the demand for drugs to cope with the illness. GlobalData, a London-based research firm, says the global asthma market will expand from around $12.4 billion in 2009 to $14 billion by 2017. Its November 2010 report stated that “competition in the asthma market is becoming intense” as a result of the emergence of new treatment options, such as combination therapies, inhaled corticosteroids and beta agonists, which target airway muscles. In fact, GlobalData identified no fewer than 229 molecules in the pharmaceutical pipeline in development against asthma.
Yet even though drug companies are racing ahead with a pharmacopeia of experimental asthma agents, a new study published last month hints that researchers still have much to learn about the systemic action of asthma drugs. The study found that pills containing anti-inflammatory drugs known as leukotriene receptor antagonists (LTRAs)—sold by AstraZeneca as Accolate (zafirlukast) and Merck as Singulair (montelukast)—were as effective as inhaled corticosteroids in treating symptoms (N. Engl. J. Med. 364, 1695–1707, 2011). The confirmation that pills might match inhalers in controlling asthma was welcome news, says study author Stanley Musgrave, an epidemiologist at the UK's University of East Anglia in Norwich. Both the oral and inhaled drugs reduce the inflammation-driven constriction of airways, but some scientists speculate that the former provides more systemic relief and perhaps acts on other parts of the body that are influencing the airways indirectly.
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