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Montelukast added to fluticasone propionate does not alter inflammation or outcomes

Djukanović, Ratko, Wilson, Susan J., Moore, Wendy C., Koenig, Steven M., Laviolette, Michel, Bleecker, Eugene, Davis, W. Bruce, Doherty, Dennis E., Olivenstein, Ronald, Israel, Elliot, Kavuru, Mani, Kleerup, Eric, Reilly, Donna S., Yancey, Steven, Edwards, Lisa D., Stauffer, John L., Dorinsky, Paul M. and Jarjour, Nizar N. (2010) Montelukast added to fluticasone propionate does not alter inflammation or outcomes Respiratory Medicine, 104, (10), pp. 1425-1435. (doi:10.1016/j.rmed.2010.04.004). (PMID:20709517).

Record type: Article


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 ?2-agonists.

Methods: Patients uncontrolled on short-acting ?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 ?2-agonists without further improvement when montelukast is added to low-dose fluticasone propionate.

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Published date: October 2010
Keywords: asthma, airway inflammation, eosinophils, bronchoscopy, fluticasone propionate, montelukast


Local EPrints ID: 183683
PURE UUID: 4f7f4f33-5ba3-4b6a-9658-4182a5b4c72f
ORCID for Ratko Djukanović: ORCID iD

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Date deposited: 03 May 2011 15:03
Last modified: 18 Jul 2017 11:55

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Author: Susan J. Wilson
Author: Wendy C. Moore
Author: Steven M. Koenig
Author: Michel Laviolette
Author: Eugene Bleecker
Author: W. Bruce Davis
Author: Dennis E. Doherty
Author: Ronald Olivenstein
Author: Elliot Israel
Author: Mani Kavuru
Author: Eric Kleerup
Author: Donna S. Reilly
Author: Steven Yancey
Author: Lisa D. Edwards
Author: John L. Stauffer
Author: Paul M. Dorinsky
Author: Nizar N. Jarjour

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