Montelukast added to fluticasone propionate does not alter inflammation or outcomes

被引：8

作者：

Djukanovic, Ratko ^{[1
]}

Wilson, Susan J. ^{[1
]}

Moore, Wendy C. ^{[2
]}

Koenig, Steven M.

Laviolette, Michel ^{[3
]}

Bleecker, Eugene R. ^{[2
]}

Davis, W. Bruce ^{[4
]}

Doherty, Dennis E. ^{[5
]}

Olivenstein, Ronald ^{[6
]}

Israel, Elliott ^{[7
]}

Kavuru, Mani S. ^{[8
]}

Kleerup, Eric ^{[9
]}

Reilly, Donna S. ^{[10
]}

Yancey, Steven W. ^{[10
]}

Edwards, Lisa D. ^{[10
]}

Stauffer, John L. ^{[11
]}

Dorinsky, Paul M. ^{[12
]}

Jarjour, Nizar N. ^{[13
]}

机构：

[1] Univ Southampton, Southampton, Hants, England

[2] Wake Forest Univ, Sch Med, Div Pulm & Crit Care Med, Winston Salem, NC 27109 USA

[3] Laval Hosp & Univ, Quebec City, PQ, Canada

[4] Med Coll Georgia, Augusta, GA 30912 USA

[5] Univ Kentucky, Lexington, KY USA

[6] McGill Univ, Meakins Christie Labs, Montreal, PQ, Canada

[7] Harvard Univ, Brigham & Womens Hosp, Sch Med, Boston, MA 02115 USA

[8] E Carolina Univ, Brody Sch Med, Div Pulm & Crit Care Med, Greenville, NC USA

[9] Pulm Med Associates Sleep Ctr, Reno, NV USA

[10] GlaxoSmithKline, Resp Med Dev Ctr, Res Triangle Pk, NC USA

[11] CV Therapeut, Palo Alto, CA USA

[12] Teva USA, Horsham, PA USA

[13] Univ Wisconsin, Sch Med & Publ Hlth, Sect Allergy Pulm & Crit Care, Madison, WI USA

来源：

RESPIRATORY MEDICINE | 2010年 / 104卷 / 10期

关键词：

Asthma; Airway inflammation; Eosinophils; Bronchoscopy; Fluticasone propionate; Montelukast; SUBEPITHELIAL COLLAGEN DEPOSITION; AIRWAY INFLAMMATION; BASEMENT-MEMBRANE; INHALED CORTICOSTEROIDS; BRONCHOALVEOLAR LAVAGE; PERSISTENT ASTHMA; MODERATE ASTHMA; MILD ASTHMA; BUDESONIDE; HYPERRESPONSIVENESS;

D O I：

10.1016/j.rmed.2010.04.004

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Airway inflammation is a key pathological feature of asthma which underlies its clinical presentation. Objectives: To examine whether adding a leukotriene modifier to an inhaled corticosteroid produces further clinical and/or anti-inflammatory benefits in patients symptomatic on short-acting beta(2)-agonists. Methods: Patients uncontrolled on short-acting beta(2)-agonists were treated for 12 weeks with either fluticasone propionate (100 mcg BD) or fluticasone propionate (100 mcg BD) and montelukast (10 mg QD) in a randomized, double-blind, parallel group study. Bronchoscopy with endobronchial biopsy and bronchoalveolar lavage (BAL) was performed before and after treatment to compare effects on airway inflammation. Results: Of 103 subjects enrolled, 89 subjects completed treatment and 82 subjects had matched pair biopsy samples. Submucosal eosinophil counts, the primary endpoint, and asthma control improved to similar extents after both treatments (p <= 0.008). Both treatments significantly reduced submucosal mast cell, CD3+, CD4+, CD8+ and CD25+ cell counts. Submucosal mast cell reduction was greater in the fluticasone propionate plus montelukast group. There were no differences between treatments in BAL markers of inflammation or thickness of sub-epithelial collagen. Conclusions: Low-dose fluticasone propionate significantly improves clinical disease control and reduces airway inflammation in asthma patients uncontrolled with short-acting beta(2)-agonists without further improvement when montelukast is added to low-dose fluticasone propionate. (C) 2010 Published by Elsevier Ltd.

引用

页码：1425 / 1435

页数：11

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