Evaluation of Salmeterol or Montelukast as Second-Line Therapy for Asthma Not Controlled With Inhaled Corticosteroids

摘要: Objective To assess the addition of a leukotriene receptor antagonist and long-acting ββ 2 -agonist as second-line therapy in asthma. Design Placebo-controlled, double-dummy, crossover study. Setting Outpatient clinic. Patients Twenty patients with persistent asthma not controlled inhaled corticosteroid therapy. Interventions Montelukast, 10 mg once daily, or salmeterol, 50 μμg bid, each for weeks 1-week run-in washout placebo periods. Measurements results Adenosine monophosphate (AMP) bronchial challenge, blood eosinophil count (EOS), exhaled nitric oxide, lung function after both periods first last doses active treatment. recorded their domiciliary peak expiratory flow (PEF), symptoms, rescue bronchodilator requirement (RES) twice daily throughout For primary end point provocative concentration AMP causing 20% fall FEV 1 , compared to (47.5 ± 13.0 mg/mL), there were significant differences (114.1 36.9 mg/mL) (94.2 30.4 montelukast well (160.1 64.5 but (70.1 23.7 dose salmeterol. Only produced suppression EOS. Neither drug affected oxide levels. There improvements salmeterol all parameters function. After treatment, drugs RES morning PEF. no between any points except Conclusions Montelukast exhibited control when given also effects on challenge EOS suggesting anti-inflammatory activity.