Professor Francine Ducharme reviewed 13 trials comparing leukotriene receptor antagonists with low doses of inhaled glucocorticoids for 28 days or more in children and adults.
She found that adults treated with leukotriene receptor antagonists were 60% more likely to suffer worsening of symptoms, whereas those treated with inhaled glucocorticoids experienced fewer night awakenings and fewer days with symptoms.
Risk of side effects was no different between groups, but leukotriene receptor antagonists were associated with a 2.5-fold increase risk of withdrawal because of poor asthma control.
There was insufficient evidence to draw conclusions about effectiveness in children.