Inhaled corticosteroids and leukotriene modifiers as mono-therapy for mild persistent asthma

Several guidelines have endorsed inhaled corticosteroids (ICs) as superior for mild persistent asthma. The use of Leukotriene modifiers has been showing an effective potential based on reports in past years. In this study the efficacy of a single daily dose of 200 mu g of inhaled fluticasone propionate was compared with that of the recommended dose of 10 mg of oral montelukast. Comparative data were based on the measurement of specific biomarkers including IgE, eosinophil count, interleukin 4 (IL-4) and fractional exhaled nitric oxide (FENO) as airway inflammation predictors and routine investigations were determined including the pulmonary function tests and Xray imaging. After week 16, the levels of FENO, IgE, Forced expiratory volume in one second (FEV1) and eosinophilia count percentage were recognized to be of lower significance in asthmatic patients treated with ICS in comparison to those under treatment of leukotriene modifiers. Also, the results revealed a significant positive correlation between FENO level and eosinophil count (r = 0.272, p = 0.047). The clinical effectiveness of a low dose of fluticasone propionate was superior clinically as a firstline of choice in patients with persistent asthma to that of mentulokast. (C) 2013 Production and hosting by Elsevier B.V. on behalf of The Egyptian Society of Chest Diseases and Tuberculosis.