Jeong-Hee Choi; Hae-Sim Park; Kwan-Ho Lee; Jae-Jeong Shim; Soo-Taek Uh; Sang-Pyo Lee; Yong-Chul Lee; Won-Il Choi; Joo-In Kim; Jae-Ho Lee; Myung-Goo Lee; Ki-Suck Jung

doi:10.4046/trd.2007.63.4.337

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Choi, Park, Lee, Shim, Uh, Lee, Lee, Choi, Kim, Lee, Lee, and Jung: The Efficacy of Added Montelukast in Persistent Asthmatics Who Were Not Completely Controlled on Inhaled Corticosteroids and Inhaled Long-acting β2-agonists

Original Article

Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2007; 63(4): 337-345.

Published online: 31 October 2007

DOI: https://doi.org/10.4046/trd.2007.63.4.337

The Efficacy of Added Montelukast in Persistent Asthmatics Who Were Not Completely Controlled on Inhaled Corticosteroids and Inhaled Long-acting β₂-agonists

Jeong-Hee Choi, M.D.¹, Hae-Sim Park, M.D.²

, Kwan-Ho Lee, M.D.³, Jae-Jeong Shim, M.D.⁴, Soo-Taek Uh, M.D.⁵, Sang-Pyo Lee, M.D.⁶, Yong-Chul Lee, M.D.⁷, Won-Il Choi, M.D.⁸, Joo-In Kim, M.D.⁹, Jae-Ho Lee, M.D.¹⁰, Myung-Goo Lee, M.D.¹, Ki-Suck Jung, M.D.¹

¹Department of Internal Medicine, College of Medicine, Hallym University, Korea.

²Department of Internal Medicine, College of Medicine, Ajou Univerity, Korea.

³Department of Internal Medicine, College of Medicine, Yeungnam University, Korea.

⁴Department of Internal Medicine, College of Medicine, Korea Universitiy, Korea.

⁵Department of Internal Medicine, College of Medicine, Soonchunhyang University, Korea.

⁶Department of Internal Medicine, College of Medicine, Gachon University, Korea.

⁷Department of Internal Medicine, College of Medicine, Chonbuk National University, Korea.

⁸Department of Internal Medicine, College of Medicine, Keimyung University, Korea.

⁹Department of Internal Medicine, College of Medicine, Seoul National University, Korea.

¹⁰Department of Internal Medicine, College of Medicine, Inje University, Korea.

Address for correspondence: Ki-Suck Jung M.D., Ph.D. Department of Pulmonology and Allergy, Hallym University Sacred Heart Hospital, 896 Pyungchon-dong, Dongan-gu, Anyang-si, Gyeonggid-do, 431-070, Korea. Phone: 82-31-380-3715~6, Fax: 82-31-380-3973, pulmoks@hallym.or.kr

Received 31 August 2007 Accepted 12 October 2007

Abstract

Background

Although glucocorticoids are one of the most potent anti-inflammatory agents, they have limited effect on cysteinyl leukotriene biosynthesis. In addition, the response to inhaled corticosteroids (ICS) and inhaled long-acting β₂-agonists (LABA) combination therapy in moderate to severe persistent asthmatics varies. Additional therapy with leukotriene receptor antagonists (LTRA) in patients with moderate to severe asthma suboptimally controlled with ICS and LABA combination therapy would be complementary to asthma control.

Methods

One hundred and ninety eight asthmatics entered a 2 month, open-label descriptive study. Patients suffering from persistent asthma and suboptimally controlled on a combination therapy of fluticasone/salmeterol or budesonide/formoterol were given montelukast 10 mg daily as an add-on therapy. The level of asthma control was assessed using the Asthma Control Questionnaire (ACQ) including FEV₁ % predicted at the baseline and after a 2-month treatment with montelukast. A global evaluation of the treatment was also made by the patients and physicians.

Results

The mean ACQ score decreased significantly on montelukast (11.5±5.4 at baseline vs. 6.7±5.0), with a significant improvement in all individual symptom scores (p<0.01). The FEV₁ % predicted values did not show any significant change. 59.9% of patients and 59.4% of physicians reported global improvement in their asthma (κ=0.85).

Conclusion

These results suggest that the addition of montelukast in patients with persistent asthma that is suboptimally contolled by combination therapy of ICS and LABA might confer complementary effects on asthma control.

Keywords: Asthma control, Inhaled glucocorticosteroid, Long-acting inhaled β2-agonist, Montelukast

Figures and Tables

Figure 1

Mean individual symptom scores of the ACQ in patients before and after addition of montelukast to fixed association(FA) of ICS plus LABA.

Figure 2

Global evaluation of asthma symptoms at visit 2.

Figure 3

Global evaluation of rhinitis symptoms at visit 2.

Table 1

Clinical characteristics of the study subjects at baseline

ACQ: athma control questionnaire; Data are expressed as mean±SD.

Table 2

Mean changes of the ACQ score and FEV1 % predictied value in patients from baseline to treatment

ACQ: athma qualitycontrol questionnaire; Data are expressed as mean±SD.

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ORCID iDs: Hae-Sim Park
https://orcid.org/http://orcid.org/0000-0003-2614-0303
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