Background: In this research, 82 patients at Naseer Teaching Hospital, Peshawar with asthma are compared for the efficacy of leukotriene receptor antagonists (LTRA) vs inhaled corticosteroids (ICS).

Methods: Patients were randomized into two groups: 41 received ICS and 41 received LTRA over a 12-month period. Baseline characteristics including age, gender, and lung function were similar between groups.

Results: Both groups' asthma control, as measured by ACT, considerably improved, with the ICS group showing better results at 3, 6, and 12 months. ICS showed greater improvements in lung function (FEV1, PEFR) and lower exacerbation rates. Quality of life (AQLQ) scores improved more with ICS. Adherence was higher with ICS (85%) compared to LTRA (76%). Adverse events were more frequent with ICS (throat irritation) and LTRA (headaches, gastrointestinal disturbances).

Conclusion: ICS is recommended as first-line treatment for persistent asthma due to superior efficacy in symptom control, lung function improvement, and quality of life enhancement. Larger, multi-center trials are needed to validate these findings and optimize global asthma management strategies.