PURPOSE: Sarcoidosis is granulomatous disease of unknown etiology and unpredictable course. It is characterized by the existence of granulomatous inflammation and in some patients with the variety of lung function impairments. Unfortunately, conventional steroid therapy is not only sufficient for their improvement. In addition to the conventional immunosuppressive therapy, some patients need the supplementary treatment in order to achieve the improvement of their lung function. The purpose of this study is to demonstrate the effects of montelukast an oral leukotrienes receptor antagonist, in the therapy of sarcoidosis patients with lung function impairments and parenchymal lesions (stage 2 and 3 of the lung disease).
METHODS: 64 biopsy positive sarcoidosis patients were analyzed. (48 female/ 16 male). All patients had chronic disease. Prior to the therapy they performed lung function tests, chest X ray and some from the analyzed group HRCT. All patients were treated with the conventional immunosuppressive therapy. 32 patients from the analyzed group (24 female/ 8 male) were also treated with oral montelukast. The evaluation of the effects of the therapy with montelukast was performed after 6 months. (Lung function, chest X ray and HRCT. Subjective feeling of breathlessness was analyzed by Modified Medical Research Council Scale (MMRC: scores range from 0 to 4; higher scores indicate more severe dyspnea.)
RESULTS: Statistically significant differences (Wilcoxon Signed Ranks Test) were found in patients treated with montelukast 6 months from the beginning: (DLCO (74% vs. 72%,: z = -3.676 ,p=.000**) FVC (97.5% vs. 92.5% z =-3.218; p=.001**), FEV1 (89% vs 86%; z =-3.076; p=.002**), KCO (78.5% vs. 78.0%; z=-3.050; p=.002**), VCIN (93.0% vs 87.5%;z= -1.977; p=.048*) and MMRC (1 vs 2; z=-2.422 , p=.015*). Statistically significant negative correlation was found between VCIN and MMRC (Spearmans rho= - 0.496).
CONCLUSIONS: Statistically significant improvement of the lung function was found in patients treated with montelukast. Chest X ray and HRCT showed significant improvement too.
CLINICAL IMPLICATIONS: The usefulness of montelukast may be the additional suppression of inflammation (granulomatous) in sarcoidosis.
DISCLOSURE: The following authors have nothing to disclose: Violeta Vucinic, Mihailo Stjepanovic, Snezana Filipovic, Maja Omcikus, Jelica Videnovic, Mira Vukovic
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