The objective of the present study was to determine whether addition of either oral sustained release theophylline or montelukast, an oral leukotriene receptor antagonist, to inhaled corticosteroids, resulted in improvement of clinical symptoms and pulmonary function parameters or not.
90 patients with chronic asthma (FEV1 50 to 85% of predicted) incompletely controlled with inhaled budesonide, 200 μg twice daily, were allocated, in a randomized, double-blind fashion, to one of three treatment groups: double dose of inhaled budesonide, oral sustained release theophylline in addition to budesonide and Montelukast 10 mg plus budesonide. The primary endpoints were FEV1 and PEFR. Pulmonary function tests were carried out at the onset of treatment, at end of 2, 4 and lastly at 8 weeks.
Patients in all groups showed a decrease in intensity of clinical features. PFT at 8 weeks showed an improvement from 211.8± 10.4 to 226.2 ± 9.1, 205.2 ± 11.4 to 223.8 ± 8.4 and 210.6 ± 11.6 to 243.6 ± 10.0 (P< 0.05) in PEFR and from 2.12 ± 0.12 to 2.31 ± 0.18, 2.07 ± 0.08 to 2.28 ± 0.10 and 2.02 ± 0.08 to 2.32 ± 0.10 (P < 0.05) in FEV1.
Use of oral leukotriene receptor antagonist along with inhaled bronchodilators and corticosteroids has a superior effect than addition of an oral sustained release theophylline or an increase in the dose of inhaled corticosteroids on clinical and pulmonary function parameters in patients of chronic bronchial asthma.
Addition of montelukast to low dose inhaled glucocorticoids results in significant improvement in lung function parameters and supports it use as a steroid sparing agent.
A.R. Shah, None.