Article Text
Abstract
Background: Proinflammatory leukotrienes, which are not completely inhibited by inhaled corticosteroids, may contribute to asthmatic problems. A 16 week multicentre, randomised, double blind, controlled study was undertaken to study the efficacy of adding oral montelukast, a leukotriene receptor antagonist, to a constant dose of inhaled budesonide.
Methods: A total of 639 patients aged 18–70 years with forced expiratory volume in 1 second (FEV1) ≥55% predicted and a minimum predefined level of asthma symptoms during a 2 week placebo run in period were randomised to receive montelukast 10 mg (n=326) or placebo (n=313) once daily for 16 weeks. All patients received a constant dose of budesonide (400–1600 μg/day) by Turbuhaler throughout the study.
Results: Mean FEV1 at baseline was 81% predicted. The median percentage of asthma exacerbation days was 35% lower (3.1% v 4.8%; p=0.03) and the median percentage of asthma free days was 56% higher (66.1% v 42.3%; p=0.001) in the montelukast group than in the placebo group. Patients receiving concomitant treatment with montelukast had significantly (p<0.05) fewer nocturnal awakenings and significantly (p<0.05) greater improvements in β agonist use and morning peak expiratory flow rate (PEFR).
Conclusions: For patients with mild airway obstruction and persistent asthma symptoms despite budesonide treatment, concomitant treatment with montelukast significantly improves asthma control.
- asthma
- montelukast
- budesonide
- add-on therapy
- leukotriene receptor antagonists
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Footnotes
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↵* A complete list of members of the CASIOPEA Study Group is provided in the Appendix.
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