Bhupendrasinh Chauhan - Academia.edu (original) (raw)
Papers by Bhupendrasinh Chauhan
Tropical Journal of Pharmaceutical Research, 2010
The Lancet Respiratory Medicine, 2016
The management of paediatric asthma exacerbations is based on trials in children of all ages. Rec... more The management of paediatric asthma exacerbations is based on trials in children of all ages. Recent studies from 2009 raised the possibility that preschoolers (younger than 6 years) with viral-induced wheezing and children exposed to tobacco smoke might be at an increased risk of treatment failure. The study objective was to identify factors associated with management failure in children presenting to the emergency department with moderate or severe asthma exacerbations. We undertook a prospective, multicentre cohort study of children aged 1-17 years presenting to five emergency departments with moderate or severe asthma (defined as a Pediatric Respiratory Assessment Measure [PRAM] of 4 to 12). Children received oral corticosteroids and severity-specific inhaled bronchodilator therapy. The primary outcome was emergency department management failure (hospital admission, prolonged emergency department therapy [≥8 h], or relapse within 72 h of discharge from the emergency department with admission to hospital or prolonged emergency department stay). Viral cause was ascertained by PCR on nasopharyngeal specimens and environmental tobacco smoke exposure by salivary cotinine concentration. This study is registered at ClinicalTrials.gov (NCT02013076). Between Feb 14, 2011, and Dec 20, 2013, we screened 1893 children and enrolled 1012 eligible children. Of those eligible children, 973 participants were included in the analysis. 165 (17%) of 965 children experienced management failure in the emergency department, which was significantly associated with viral detection (110 [19%] of 579 participants with virus detection vs 46 [13%] of 354 participants without viral detection, odds ratio [OR] 1·57; 95% CI 1·04-2·37), fever (24% vs 15%, 1·96; 1·32-2·92), baseline PRAM (OR 1·38 per 1-point increase; 1·22-1·56), oxygen saturation of less than 92% (50% vs 12%, 3·94; 1·97-7·89), and presence of symptoms between exacerbations (21% vs 16%, 1·73; 1·13-2·64). Age, salivary cotinine concentration, and oral corticosteroids dose were not significantly associated with management failure. Viral detection (67% vs 46%, p<0·0001) and fever (31% vs 16%, p<0·0001) occurred more frequently in preschoolers than in older children. Viral detection was also associated with reduced speed of recovery over the 10 days after discharge. In children presenting with moderate or severe asthma, viral detection, but not age, was associated with failure of symptom management, independently from exacerbation severity (ie, baseline PRAM and oxygen saturation), fever, and symptom chronicity (viral detection). Although it did not reach statistical significance, the association between treatment management failure and exposure to tobacco smoke warrants further investigation. Canadian Institutes of Health Research.
Indian Journal of Pharmaceutical Sciences, Jul 1, 2006
![Research paper thumbnail of Design, synthesis and in vitro antibacterial and antifungal activities of some novel spiro[azetidine-2,3′-indole]-2,4(1′H)-dione](https://attachments.academia-assets.com/49915982/thumbnails/1.jpg)
](Medicinal Chemistry Research, 2011
The present study deals with the synthesis of novel spiro[azetidine-2,3 0 -indole]-2 0 ,4(1 0 H)-... more The present study deals with the synthesis of novel spiro[azetidine-2,3 0 -indole]-2 0 ,4(1 0 H)-dione derivative from the reactions of 3-(phenylimino)-1,3-dihydro-2Hindol-2-one derivatives with chloracetyl chloride in the presence of triethylamine (TEA). All the compounds were characterized using IR, 1 H-NMR, MS, and elemental analysis. They were screened for their antibacterial and antifungal activities. The bacterial strains used were Grampositive Staphylococcus aureus (MTCC-96) and Gramnegative Escherichia coli (MTCC-521) and Pseudomonas aeruginosa (MTCC-647). The antifungal screening was done on Candida albicans (MTCC-183) and Asperigillus niger (MTCC-343) fungal strains. Results revealed that, compounds (7a), (7b), (7c), (7d), and (7e) showed very good activity with MIC value of 6.25-12.5 lg/ml against three evaluated bacterial strains and the remaining compounds showed good to moderate activity comparable to standard drugs as antibacterial agents. Compounds (7c) and (7h) displayed equipotent antifungal activity in comparison to standard drugs. Amoxicillin, gentamycin, and streptomycin were used as standard drugs for antibacterial activity while fluconazole and itraconazole were used as standard drugs for antifungal activity. Structure-activity relationship study of the compounds showed that the presence of electron withdrawing group substitution at 5 0 and 7 0 positions of indoline ring and on ortho or para position of phenyl ring increases both antibacterial and antifungal activity of the compound. Henceforth, our findings will have a good impact on chemists and biochemists for further investigations in search of spiro-fused antimicrobial agents.
Med Chem Res, 2011
The present study deals with the synthesis of novel spiro[azetidine-2,3 0 -indole]-2 0 ,4(1 0 H)-... more The present study deals with the synthesis of novel spiro[azetidine-2,3 0 -indole]-2 0 ,4(1 0 H)-dione derivative from the reactions of 3-(phenylimino)-1,3-dihydro-2Hindol-2-one derivatives with chloracetyl chloride in the presence of triethylamine (TEA). All the compounds were characterized using IR, 1 H-NMR, MS, and elemental analysis. They were screened for their antibacterial and antifungal activities. The bacterial strains used were Grampositive Staphylococcus aureus (MTCC-96) and Gramnegative Escherichia coli (MTCC-521) and Pseudomonas aeruginosa (MTCC-647). The antifungal screening was done on Candida albicans (MTCC-183) and Asperigillus niger (MTCC-343) fungal strains. Results revealed that, compounds (7a), (7b), (7c), (7d), and (7e) showed very good activity with MIC value of 6.25-12.5 lg/ml against three evaluated bacterial strains and the remaining compounds showed good to moderate activity comparable to standard drugs as antibacterial agents. Compounds (7c) and (7h) displayed equipotent antifungal activity in comparison to standard drugs. Amoxicillin, gentamycin, and streptomycin were used as standard drugs for antibacterial activity while fluconazole and itraconazole were used as standard drugs for antifungal activity. Structure-activity relationship study of the compounds showed that the presence of electron withdrawing group substitution at 5 0 and 7 0 positions of indoline ring and on ortho or para position of phenyl ring increases both antibacterial and antifungal activity of the compound. Henceforth, our findings will have a good impact on chemists and biochemists for further investigations in search of spiro-fused antimicrobial agents.
Current Clinical Pharmacology, 2008
Background: Asthma and allergic rhinitis are symptomatically as well as pathophysiologically over... more Background: Asthma and allergic rhinitis are symptomatically as well as pathophysiologically overlapping conditions and their prevalence is increasing at an alarming rate. Despite significant progress in pathophysiology of asthma and allergic rhinitis and availability of several therapies in recent years, a true and complete cure for asthma and allergic rhinitis so far seems out of reach.
Indian Journal of Pharmaceutical Sciences
Tropical Journal of Pharmaceutical Research
Abstract Objectives: To compare the safety and efficacy of LTRA with ICS in patients with asthma ... more Abstract Objectives: To compare the safety and efficacy of LTRA with ICS in patients with asthma across age groups, over time, baseline severity and ICS dose. Methods: In a systematic review until Dec 2010, we included randomised controlled trials comparing LTRA to ICS for ≥30 days in children and adults with asthma. The primary outcome was exacerbation requiring systemic steroids. Secondary outcomes included lung function, asthma control, adverse effects and withdrawals. Results: The 54 included trials comprised 13,460 patients (2,795 children) with mild (42%) or moderate (58%) airway obstruction. In 84% of trials, LTRA was compared to a low ICS dose over 4-52 weeks. Compared to ICS, 48% more patients treated with LTRA suffered exacerbations requiring systemic steroids (RR 1.48; 95% CI 1.18, 1.85). There was no significant difference in the magnitude of effect between children and adults, ICS dose, and over time. The benefit of ICS over LTRA was greater in patients with moderate vs...
Journal of Allergy & Therapy, 2013
Background: Although guidelines recommend maintenance inhaled corticosteroids (ICS) in mild persi... more Background: Although guidelines recommend maintenance inhaled corticosteroids (ICS) in mild persistent asthma, most patients use, and many physicians prescribe, intermittent ICS.
The Lancet, 2014
'with wheeze' correct? Or 'wheeze or asthma'?], representing a diagnostic challenge. Although sev... more 'with wheeze' correct? Or 'wheeze or asthma'?], representing a diagnostic challenge. Although several phenotype classifications have been described, none have been validated to identify individuals responding to specific therapeutic approaches. Several risk factors related to genetic, prenatal, and postnatal environment are associated with preschool wheezing. Findings from several cohort studies have shown that preschool children with wheeze have deficits in lung function at 6 years of age that persisted until early and middle adulthood, suggesting increased susceptibility in the first years of life that might lead to persistent sequelae. Daily inhaled corticosteroids seem to be the most effective therapy for recurrent wheezing in trials of children with intermittent symptoms or atopy; intermittent high-dose inhaled corticosteroids are effective in moderate-to-severe viral-induced wheezing without intermittent symptoms. The role of leukotriene receptor antagonist is less clear. Interventions to modify the short-term and long-term outcomes of preschool wheeze should be a research priority.
The Cochrane database of systematic reviews, Jan 31, 2014
Inhaled anticholinergics given in addition to β2-agonists are effective in reducing hospital admi... more Inhaled anticholinergics given in addition to β2-agonists are effective in reducing hospital admissions in children presenting to the emergency department with a moderate to severe asthma exacerbation. It seems logical to assume a similar beneficial effect in children hospitalised for an acute asthma exacerbation. To assess the efficacy and safety of anticholinergics added to β2-agonists as inhaled or nebulised therapy in children hospitalised for an acute asthma exacerbation. To investigate the characteristics of patients or therapy, if any, that would influence the magnitude of response attributable to the addition of anticholinergics. We identified trials from the Cochrane Airways Group Specialised Register of trials (CAGR), which is derived through systematic searches of bibliographic databases including the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, AMED and PsycINFO and through handsearching of respiratory journals and meeting abstracts....
The Cochrane database of systematic reviews, Jan 24, 2014
Asthma patients who continue to experience symptoms despite taking regular inhaled corticosteroid... more Asthma patients who continue to experience symptoms despite taking regular inhaled corticosteroids (ICS) represent a management challenge. Long-acting beta2-agonists (LABA) and anti-leukotrienes (LTRA) are two treatment options that could be considered as add-on therapy to ICS. To compare the safety and efficacy of adding LABA versus LTRA to the treatment regimen for children and adults with asthma who remain symptomatic in spite of regular treatment with ICS. We specifically wished to examine the relative impact of the two agents on asthma exacerbations, lung function, symptoms, quality of life, adverse health events and withdrawals. We searched the Cochrane Airways Group Specialised Register until December 2012. We consulted reference lists of all included studies and contacted pharmaceutical manufacturers to ask about other published or unpublished studies. We included randomised controlled trials (RCTs) conducted in adults or children with recurrent asthma that was treated with ...
The Cochrane database of systematic reviews, Jan 12, 2012
Daily inhaled corticosteroids (ICS) are the recommended mainstay of treatment in children and adu... more Daily inhaled corticosteroids (ICS) are the recommended mainstay of treatment in children and adults with persistent asthma. Yet often, ICS are used intermittently by patients or recommended by physicians to be used only at the onset of exacerbations. The aim of this review was to compare the efficacy and safety of intermittent versus daily ICS in the management of children and adults with persistent asthma and preschool-aged children suspected of persistent asthma. We searched the Cochrane Airways Group Specialised Register of trials (CAGR) and the ClinicalTrials.gov website up to December 2011. We included randomised controlled trials (RCTs) that compared intermittent ICS versus daily ICS in children and adults with persistent asthma. No co-interventions were permitted other than rescue relievers and oral corticosteroids used during exacerbations. Two review authors independently assessed trials for inclusion, methodological quality and extracted data. The primary efficacy outcome...
The Cochrane database of systematic reviews, 2000
Inhaled corticosteroids are the cornerstone of anti-inflammatory asthma treatment. Anti-leukotrie... more Inhaled corticosteroids are the cornerstone of anti-inflammatory asthma treatment. Anti-leukotrienes agents are currently being studied as alternative first line agents in the management of mild to moderate chronic asthma. The aims of this review study are to compare the safety and efficacy of anti-leukotriene agents with inhaled glucocorticoids and to determine the dose-equivalence of anti-leukotrienes in mcg of inhaled corticosteroids in the management of chronic asthma. The searched Medline (1966 to 1999), Embase (1980 to 1999), Cinahl (1982 to 1999) and reference lists of review articles and trials; we contacted colleagues and international headquarters of anti-leukotrienes producers. Randomised controlled trials were included if they compared leukotriene antagonists with inhaled corticosteroids during a minimal 30-day intervention period in asthmatic patients aged 2 years and older, and if measures of effectiveness other than compliance were included. Assessments of methodologi...
Tropical Journal of Pharmaceutical Research, 2010
The Lancet Respiratory Medicine, 2016
The management of paediatric asthma exacerbations is based on trials in children of all ages. Rec... more The management of paediatric asthma exacerbations is based on trials in children of all ages. Recent studies from 2009 raised the possibility that preschoolers (younger than 6 years) with viral-induced wheezing and children exposed to tobacco smoke might be at an increased risk of treatment failure. The study objective was to identify factors associated with management failure in children presenting to the emergency department with moderate or severe asthma exacerbations. We undertook a prospective, multicentre cohort study of children aged 1-17 years presenting to five emergency departments with moderate or severe asthma (defined as a Pediatric Respiratory Assessment Measure [PRAM] of 4 to 12). Children received oral corticosteroids and severity-specific inhaled bronchodilator therapy. The primary outcome was emergency department management failure (hospital admission, prolonged emergency department therapy [≥8 h], or relapse within 72 h of discharge from the emergency department with admission to hospital or prolonged emergency department stay). Viral cause was ascertained by PCR on nasopharyngeal specimens and environmental tobacco smoke exposure by salivary cotinine concentration. This study is registered at ClinicalTrials.gov (NCT02013076). Between Feb 14, 2011, and Dec 20, 2013, we screened 1893 children and enrolled 1012 eligible children. Of those eligible children, 973 participants were included in the analysis. 165 (17%) of 965 children experienced management failure in the emergency department, which was significantly associated with viral detection (110 [19%] of 579 participants with virus detection vs 46 [13%] of 354 participants without viral detection, odds ratio [OR] 1·57; 95% CI 1·04-2·37), fever (24% vs 15%, 1·96; 1·32-2·92), baseline PRAM (OR 1·38 per 1-point increase; 1·22-1·56), oxygen saturation of less than 92% (50% vs 12%, 3·94; 1·97-7·89), and presence of symptoms between exacerbations (21% vs 16%, 1·73; 1·13-2·64). Age, salivary cotinine concentration, and oral corticosteroids dose were not significantly associated with management failure. Viral detection (67% vs 46%, p<0·0001) and fever (31% vs 16%, p<0·0001) occurred more frequently in preschoolers than in older children. Viral detection was also associated with reduced speed of recovery over the 10 days after discharge. In children presenting with moderate or severe asthma, viral detection, but not age, was associated with failure of symptom management, independently from exacerbation severity (ie, baseline PRAM and oxygen saturation), fever, and symptom chronicity (viral detection). Although it did not reach statistical significance, the association between treatment management failure and exposure to tobacco smoke warrants further investigation. Canadian Institutes of Health Research.
Indian Journal of Pharmaceutical Sciences, Jul 1, 2006
Medicinal Chemistry Research, 2011
The present study deals with the synthesis of novel spiro[azetidine-2,3 0 -indole]-2 0 ,4(1 0 H)-... more The present study deals with the synthesis of novel spiro[azetidine-2,3 0 -indole]-2 0 ,4(1 0 H)-dione derivative from the reactions of 3-(phenylimino)-1,3-dihydro-2Hindol-2-one derivatives with chloracetyl chloride in the presence of triethylamine (TEA). All the compounds were characterized using IR, 1 H-NMR, MS, and elemental analysis. They were screened for their antibacterial and antifungal activities. The bacterial strains used were Grampositive Staphylococcus aureus (MTCC-96) and Gramnegative Escherichia coli (MTCC-521) and Pseudomonas aeruginosa (MTCC-647). The antifungal screening was done on Candida albicans (MTCC-183) and Asperigillus niger (MTCC-343) fungal strains. Results revealed that, compounds (7a), (7b), (7c), (7d), and (7e) showed very good activity with MIC value of 6.25-12.5 lg/ml against three evaluated bacterial strains and the remaining compounds showed good to moderate activity comparable to standard drugs as antibacterial agents. Compounds (7c) and (7h) displayed equipotent antifungal activity in comparison to standard drugs. Amoxicillin, gentamycin, and streptomycin were used as standard drugs for antibacterial activity while fluconazole and itraconazole were used as standard drugs for antifungal activity. Structure-activity relationship study of the compounds showed that the presence of electron withdrawing group substitution at 5 0 and 7 0 positions of indoline ring and on ortho or para position of phenyl ring increases both antibacterial and antifungal activity of the compound. Henceforth, our findings will have a good impact on chemists and biochemists for further investigations in search of spiro-fused antimicrobial agents.
Med Chem Res, 2011
The present study deals with the synthesis of novel spiro[azetidine-2,3 0 -indole]-2 0 ,4(1 0 H)-... more The present study deals with the synthesis of novel spiro[azetidine-2,3 0 -indole]-2 0 ,4(1 0 H)-dione derivative from the reactions of 3-(phenylimino)-1,3-dihydro-2Hindol-2-one derivatives with chloracetyl chloride in the presence of triethylamine (TEA). All the compounds were characterized using IR, 1 H-NMR, MS, and elemental analysis. They were screened for their antibacterial and antifungal activities. The bacterial strains used were Grampositive Staphylococcus aureus (MTCC-96) and Gramnegative Escherichia coli (MTCC-521) and Pseudomonas aeruginosa (MTCC-647). The antifungal screening was done on Candida albicans (MTCC-183) and Asperigillus niger (MTCC-343) fungal strains. Results revealed that, compounds (7a), (7b), (7c), (7d), and (7e) showed very good activity with MIC value of 6.25-12.5 lg/ml against three evaluated bacterial strains and the remaining compounds showed good to moderate activity comparable to standard drugs as antibacterial agents. Compounds (7c) and (7h) displayed equipotent antifungal activity in comparison to standard drugs. Amoxicillin, gentamycin, and streptomycin were used as standard drugs for antibacterial activity while fluconazole and itraconazole were used as standard drugs for antifungal activity. Structure-activity relationship study of the compounds showed that the presence of electron withdrawing group substitution at 5 0 and 7 0 positions of indoline ring and on ortho or para position of phenyl ring increases both antibacterial and antifungal activity of the compound. Henceforth, our findings will have a good impact on chemists and biochemists for further investigations in search of spiro-fused antimicrobial agents.
Current Clinical Pharmacology, 2008
Background: Asthma and allergic rhinitis are symptomatically as well as pathophysiologically over... more Background: Asthma and allergic rhinitis are symptomatically as well as pathophysiologically overlapping conditions and their prevalence is increasing at an alarming rate. Despite significant progress in pathophysiology of asthma and allergic rhinitis and availability of several therapies in recent years, a true and complete cure for asthma and allergic rhinitis so far seems out of reach.
Indian Journal of Pharmaceutical Sciences
Tropical Journal of Pharmaceutical Research
Abstract Objectives: To compare the safety and efficacy of LTRA with ICS in patients with asthma ... more Abstract Objectives: To compare the safety and efficacy of LTRA with ICS in patients with asthma across age groups, over time, baseline severity and ICS dose. Methods: In a systematic review until Dec 2010, we included randomised controlled trials comparing LTRA to ICS for ≥30 days in children and adults with asthma. The primary outcome was exacerbation requiring systemic steroids. Secondary outcomes included lung function, asthma control, adverse effects and withdrawals. Results: The 54 included trials comprised 13,460 patients (2,795 children) with mild (42%) or moderate (58%) airway obstruction. In 84% of trials, LTRA was compared to a low ICS dose over 4-52 weeks. Compared to ICS, 48% more patients treated with LTRA suffered exacerbations requiring systemic steroids (RR 1.48; 95% CI 1.18, 1.85). There was no significant difference in the magnitude of effect between children and adults, ICS dose, and over time. The benefit of ICS over LTRA was greater in patients with moderate vs...
Journal of Allergy & Therapy, 2013
Background: Although guidelines recommend maintenance inhaled corticosteroids (ICS) in mild persi... more Background: Although guidelines recommend maintenance inhaled corticosteroids (ICS) in mild persistent asthma, most patients use, and many physicians prescribe, intermittent ICS.
The Lancet, 2014
'with wheeze' correct? Or 'wheeze or asthma'?], representing a diagnostic challenge. Although sev... more 'with wheeze' correct? Or 'wheeze or asthma'?], representing a diagnostic challenge. Although several phenotype classifications have been described, none have been validated to identify individuals responding to specific therapeutic approaches. Several risk factors related to genetic, prenatal, and postnatal environment are associated with preschool wheezing. Findings from several cohort studies have shown that preschool children with wheeze have deficits in lung function at 6 years of age that persisted until early and middle adulthood, suggesting increased susceptibility in the first years of life that might lead to persistent sequelae. Daily inhaled corticosteroids seem to be the most effective therapy for recurrent wheezing in trials of children with intermittent symptoms or atopy; intermittent high-dose inhaled corticosteroids are effective in moderate-to-severe viral-induced wheezing without intermittent symptoms. The role of leukotriene receptor antagonist is less clear. Interventions to modify the short-term and long-term outcomes of preschool wheeze should be a research priority.
The Cochrane database of systematic reviews, Jan 31, 2014
Inhaled anticholinergics given in addition to β2-agonists are effective in reducing hospital admi... more Inhaled anticholinergics given in addition to β2-agonists are effective in reducing hospital admissions in children presenting to the emergency department with a moderate to severe asthma exacerbation. It seems logical to assume a similar beneficial effect in children hospitalised for an acute asthma exacerbation. To assess the efficacy and safety of anticholinergics added to β2-agonists as inhaled or nebulised therapy in children hospitalised for an acute asthma exacerbation. To investigate the characteristics of patients or therapy, if any, that would influence the magnitude of response attributable to the addition of anticholinergics. We identified trials from the Cochrane Airways Group Specialised Register of trials (CAGR), which is derived through systematic searches of bibliographic databases including the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, AMED and PsycINFO and through handsearching of respiratory journals and meeting abstracts....
The Cochrane database of systematic reviews, Jan 24, 2014
Asthma patients who continue to experience symptoms despite taking regular inhaled corticosteroid... more Asthma patients who continue to experience symptoms despite taking regular inhaled corticosteroids (ICS) represent a management challenge. Long-acting beta2-agonists (LABA) and anti-leukotrienes (LTRA) are two treatment options that could be considered as add-on therapy to ICS. To compare the safety and efficacy of adding LABA versus LTRA to the treatment regimen for children and adults with asthma who remain symptomatic in spite of regular treatment with ICS. We specifically wished to examine the relative impact of the two agents on asthma exacerbations, lung function, symptoms, quality of life, adverse health events and withdrawals. We searched the Cochrane Airways Group Specialised Register until December 2012. We consulted reference lists of all included studies and contacted pharmaceutical manufacturers to ask about other published or unpublished studies. We included randomised controlled trials (RCTs) conducted in adults or children with recurrent asthma that was treated with ...
The Cochrane database of systematic reviews, Jan 12, 2012
Daily inhaled corticosteroids (ICS) are the recommended mainstay of treatment in children and adu... more Daily inhaled corticosteroids (ICS) are the recommended mainstay of treatment in children and adults with persistent asthma. Yet often, ICS are used intermittently by patients or recommended by physicians to be used only at the onset of exacerbations. The aim of this review was to compare the efficacy and safety of intermittent versus daily ICS in the management of children and adults with persistent asthma and preschool-aged children suspected of persistent asthma. We searched the Cochrane Airways Group Specialised Register of trials (CAGR) and the ClinicalTrials.gov website up to December 2011. We included randomised controlled trials (RCTs) that compared intermittent ICS versus daily ICS in children and adults with persistent asthma. No co-interventions were permitted other than rescue relievers and oral corticosteroids used during exacerbations. Two review authors independently assessed trials for inclusion, methodological quality and extracted data. The primary efficacy outcome...
The Cochrane database of systematic reviews, 2000
Inhaled corticosteroids are the cornerstone of anti-inflammatory asthma treatment. Anti-leukotrie... more Inhaled corticosteroids are the cornerstone of anti-inflammatory asthma treatment. Anti-leukotrienes agents are currently being studied as alternative first line agents in the management of mild to moderate chronic asthma. The aims of this review study are to compare the safety and efficacy of anti-leukotriene agents with inhaled glucocorticoids and to determine the dose-equivalence of anti-leukotrienes in mcg of inhaled corticosteroids in the management of chronic asthma. The searched Medline (1966 to 1999), Embase (1980 to 1999), Cinahl (1982 to 1999) and reference lists of review articles and trials; we contacted colleagues and international headquarters of anti-leukotrienes producers. Randomised controlled trials were included if they compared leukotriene antagonists with inhaled corticosteroids during a minimal 30-day intervention period in asthmatic patients aged 2 years and older, and if measures of effectiveness other than compliance were included. Assessments of methodologi...