Formoterol, montelukast, and budesonide in asthmatic children: Effect on lung function and exhaled nitric oxide

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• 作者：Michele Miraglia del Giudice ; Giorgio L. Piacentini ; Michele Capasso ; Carlo Capristo ; Nunzia Maiello ; Attilio L. Boner ; Angelo F. Capristo
• 关键词：Asthma ; Budesonide ; Exhaled nitric oxide ; FEV₁ ; Formoterol ; Montelukast
• 刊名：Respiratory Medicine
• 出版年：2007
• 出版时间：August 2007
• 年：2007
• 卷：101
• 期：8
• 页码：1809-1813
• 全文大小：207 K

文摘

It has been proposed that asthma control may be achieved in part by minimizing airway inflammation. The simultaneous effects of inhaled steroids associated with long-acting β-agonists and leukotriene antagonists on pulmonary function and airway inflammation are still largely unexplored in children with moderate persistent asthma.

Objectives

The aim of this study was to investigate the effects of add-on therapy with long-acting β-agonists and leukotriene antagonists on FEV₁ and exhaled nitric oxide levels (FE_NO) in children.

Methods

Forty-eight steroid-naïve atopic asthmatic children, 7–11 years of age, were randomly treated in four groups for two consecutive one-month periods, as follows: (1) first month: budesonide 200 μg twice daily; second month: budesonide 400 μg twice daily; (2) first month: budesonide 200 μg twice daily+formoterol 9 μg twice daily; second month: budesonide 200 μg twice daily+montelukast 5 mg once daily; (3) first month: budesonide 200 μg twice daily+montelukast 5 mg once daily; second month budesonide 200 μg+formoterol 9 μg twice daily; (4) first and second month: budesonide 400 μg twice daily.

Results

All treatments resulted in a significant increase in lung function and a decrease in FE_NO compared with values at baseline. Budesonide+montelukast in combination was the most effective treatment for reducing FE_NO levels.

Conclusion

This study demonstrates that add-on therapy with montelukast plus low-dose budesonide is more effective than the addition of long-acting β-agonists or doubling the dose of budesonide for controlling FE_NO in asthmatic children.