TITLE

Steroid naive eosinophilic asthma: anti-inflammatory effects of fluticasone and montelukast

AUTHOR(S)
Joyaram, L.; Pizzichini, E.; Lemière, C.; Man, S. F. P.; Cartier, A.; Hargreave, F. E.; Pizzichini, M. M. M.
PUB. DATE
February 2005
SOURCE
Thorax;Feb2005, Vol. 60 Issue 2, p100
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Inhaled corticosteroids and leukotriene receptor antagonists reduce airway eosinophilia and have been used as first line anti-inflammatory therapy for mild persistent asthma. Methods: A multicentre, rondomised, placebo controlled, parallel group study was performed to compare the anti-inflammatory effects of fluticasone propionate and montelukast as measured by sputum eosinophils in 50 adults with symptomatic steroid naive asthma and sputum eosinophilia of ⩾3.5%. Results: Eighteen patients received low dose fluticasone (250 μg/day), 19 received monteiukost (10 μg/day), and 13 were given placebo for 8 weeks. Fluticasone treatment resulted in a greater reduction in sputum eosinophils (geometric mean (SD) 1 1.9 (2.3)% to 1.7(5.1 )%) than montelukast (10.7 (2.3)% to 6.9 (3.8)%; p=0.04) or placebo (15.4 (2.4)% to 7.8 (4.2)%; p =0.002), and improvement in FEV1 (mean (SD) 2.6(0.9) Ito 3.0(0.9) 1) than montelukast (2.8 (0.7) Ito 2.8(0.9)1; p=0.02)orplacebo(2.4(O.S) Ito 2.4 (0.9)1; p = 0.01). Treatment with fluticasone suppressed sputum eosinophilia within a week while montelukast only attenuated it. The effect of montetukast was maximal at 1 week and was maintained over 4 weeks. The effect of fluticasone was maintained over 8 weeks while that of montelukast was not. conclusions: Montelukast is not as effective as low dose fluticasone in reducing or maintaining an anti- inflammatory effect in steroid naive eosinophilic asthma.
ACCESSION #
16301611

 

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