Abstract
Background: Current guidelines advocate the use of preventative anti-inflammatory therapy for mild persistent asthma.
Objective: We compared the efficacy and anti-inflammatory profiles of a leukotriene receptor antagonist and a low dose of inhaled corticosteroid in patients with mild persistent asthma.
Methods: Twenty-one adult patients with mild asthma received 4 weeks of either once-daily inhaled hydrofluoroalkane triamcinolone acetonide (450 μg/day ex-actuator dose) or oral montelukast (10 mg/day) in a randomized, placebo-controlled, single-blinded crossover study. Measurements were made before and after 2 and 4 weeks of each treatment.
Results: At the endpoint (after 4 weeks), triamcinolone and montelukast had improved the primary outcome (provocative dose of methacholine required to produce a 20% fall in FEV1) in comparison with placebo (P <.05), there being no difference between the treatments (1.09-fold; 95% CI 0.73 to 1.63). Triamcinolone was better than placebo or montelukast for effects on all other surrogate inflammatory markers (P <.05), including exhaled nitric oxide, blood eosinophils, serum eosinophil cationic protein, plasma intracellular circulating adhesion molecule 1, and plasma E-selectin. Both treatments improved (P <.05) morning and evening peak flow, nighttime β2-agonist use, and symptoms in comparison with placebo, though triamcinolone was better than montelukast (P <.05) with regard to peak flow. Triamcinolone produced suppression (P <.05) of overnight urinary cortisol/creatinine and serum osteocalcin.
Conclusion: Once-daily inhaled corticosteroid and leukotriene antagonist improved the primary outcome variable of bronchial hyperresponsiveness to a similar degree.
Original language | English |
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Pages (from-to) | 68-74 |
Number of pages | 7 |
Journal | Journal of Allergy and Clinical Immunology |
Volume | 109 |
Issue number | 1 |
DOIs | |
Publication status | Published - Jan 2002 |
Keywords
- Adenosine monophosphate
- Asthma
- Corticosteroid
- Inflammation
- Leukotriene antagonist
- Methacholine
- Montelukast
- Triamcinolone acetonide
ASJC Scopus subject areas
- Immunology and Allergy
- Immunology