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. 2003 Mar;58(3):204–210. doi: 10.1136/thorax.58.3.204

Effect of montelukast added to inhaled budesonide on control of mild to moderate asthma

M Vaquerizo 1, P Casan 1, J Castillo 1, M Perpina 1, J Sanchis 1, V Sobradillo 1, A Valencia 1, H Verea 1, J Viejo 1, C Villasante 1, J Gonzalez-Esteban 1, C Picado 1
PMCID: PMC1746619  PMID: 12612294

Abstract

Background: Proinflammatory leukotrienes, which are not completely inhibited by inhaled corticosteroids, may contribute to asthmatic problems. A 16 week multicentre, randomised, double blind, controlled study was undertaken to study the efficacy of adding oral montelukast, a leukotriene receptor antagonist, to a constant dose of inhaled budesonide.

Methods: A total of 639 patients aged 18–70 years with forced expiratory volume in 1 second (FEV1) ≥55% predicted and a minimum predefined level of asthma symptoms during a 2 week placebo run in period were randomised to receive montelukast 10 mg (n=326) or placebo (n=313) once daily for 16 weeks. All patients received a constant dose of budesonide (400–1600 µg/day) by Turbuhaler throughout the study.

Results: Mean FEV1 at baseline was 81% predicted. The median percentage of asthma exacerbation days was 35% lower (3.1% v 4.8%; p=0.03) and the median percentage of asthma free days was 56% higher (66.1% v 42.3%; p=0.001) in the montelukast group than in the placebo group. Patients receiving concomitant treatment with montelukast had significantly (p<0.05) fewer nocturnal awakenings and significantly (p<0.05) greater improvements in ß agonist use and morning peak expiratory flow rate (PEFR).

Conclusions: For patients with mild airway obstruction and persistent asthma symptoms despite budesonide treatment, concomitant treatment with montelukast significantly improves asthma control.

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Selected References

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