Tags

Type your tag names separated by a space and hit enter

Low-dose inhaled fluticasone propionate versus oral zafirlukast in the treatment of persistent asthma.

Abstract

BACKGROUND

Few studies have compared the efficacy of inhaled corticosteroids and leukotriene modifiers for the treatment of persistent asthma.

OBJECTIVE

Our purpose was to compare the efficacy of a low dose of inhaled fluticasone propionate (FP) with that of oral zafirlukast in the treatment of persistent asthma previously treated with short-acting beta(2)-agonists alone.

METHODS

A 12-week, randomized, double-blind, double-dummy, multicenter study was conducted in 451 patients aged 12 years and older with asthma who were symptomatic on short-acting beta(2)-agonists alone. After an 8- to 14-day run-in period, patients were randomized to treatment with FP 88 microg twice daily or zafirlukast 20 mg twice daily.

RESULTS

Treatment with FP was more effective than treatment with zafirlukast in increasing morning FEV(1) (by 0.42 L vs 0.20 L over baseline, P <.001), morning peak expiratory flow (by 49.94 L/min vs 11.68 L/min over baseline, P <. 001), and evening PEF (by 38.91 L/min vs 10.50 L/min over baseline, P <.001). Statistically significant differences between the two treatments in FEV(1) were noted after the first observation (week 4) and in morning and evening peak expiratory flow by week 2. Mean change in percentage of symptom-free days was greater with FP than with zafirlukast (28.5% of days vs 15.6% of days, P <.001) and FP significantly increased the percentage of rescue-free days by 40.4% of days compared with 24.2% of days with zafirlukast (P <.001). Treatment with FP significantly reduced albuterol use by 2.39 puffs per day compared with 1.45 puffs per day (P <.001) and increased the percentage of nights with no awakenings by 21.2% of nights compared with 8.0% of nights with zafirlukast (P <.001).

CONCLUSION

The clinical effectiveness of a low dose of FP as first-line therapy in patients with persistent asthma who are symptomatic on beta(2)-agonists alone is superior to that of zafirlukast.

Links

  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    University of Maryland School of Medicine, Baltimore, MD 21201, USA.

    , , , , ,

    Source

    MeSH

    Administration, Inhalation
    Administration, Oral
    Adult
    Aged
    Androstadienes
    Anti-Asthmatic Agents
    Asthma
    Child
    Dose-Response Relationship, Drug
    Female
    Fluticasone
    Forced Expiratory Volume
    Humans
    Male
    Middle Aged
    Therapeutic Equivalency
    Tosyl Compounds

    Pub Type(s)

    Clinical Trial
    Journal Article
    Multicenter Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    10856145

    Citation

    Bleecker, E R., et al. "Low-dose Inhaled Fluticasone Propionate Versus Oral Zafirlukast in the Treatment of Persistent Asthma." The Journal of Allergy and Clinical Immunology, vol. 105, no. 6 Pt 1, 2000, pp. 1123-9.
    Bleecker ER, Welch MJ, Weinstein SF, et al. Low-dose inhaled fluticasone propionate versus oral zafirlukast in the treatment of persistent asthma. J Allergy Clin Immunol. 2000;105(6 Pt 1):1123-9.
    Bleecker, E. R., Welch, M. J., Weinstein, S. F., Kalberg, C., Johnson, M., Edwards, L., & Rickard, K. A. (2000). Low-dose inhaled fluticasone propionate versus oral zafirlukast in the treatment of persistent asthma. The Journal of Allergy and Clinical Immunology, 105(6 Pt 1), pp. 1123-9.
    Bleecker ER, et al. Low-dose Inhaled Fluticasone Propionate Versus Oral Zafirlukast in the Treatment of Persistent Asthma. J Allergy Clin Immunol. 2000;105(6 Pt 1):1123-9. PubMed PMID: 10856145.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Low-dose inhaled fluticasone propionate versus oral zafirlukast in the treatment of persistent asthma. AU - Bleecker,E R, AU - Welch,M J, AU - Weinstein,S F, AU - Kalberg,C, AU - Johnson,M, AU - Edwards,L, AU - Rickard,K A, PY - 2000/6/16/pubmed PY - 2000/8/12/medline PY - 2000/6/16/entrez SP - 1123 EP - 9 JF - The Journal of allergy and clinical immunology JO - J. Allergy Clin. Immunol. VL - 105 IS - 6 Pt 1 N2 - BACKGROUND: Few studies have compared the efficacy of inhaled corticosteroids and leukotriene modifiers for the treatment of persistent asthma. OBJECTIVE: Our purpose was to compare the efficacy of a low dose of inhaled fluticasone propionate (FP) with that of oral zafirlukast in the treatment of persistent asthma previously treated with short-acting beta(2)-agonists alone. METHODS: A 12-week, randomized, double-blind, double-dummy, multicenter study was conducted in 451 patients aged 12 years and older with asthma who were symptomatic on short-acting beta(2)-agonists alone. After an 8- to 14-day run-in period, patients were randomized to treatment with FP 88 microg twice daily or zafirlukast 20 mg twice daily. RESULTS: Treatment with FP was more effective than treatment with zafirlukast in increasing morning FEV(1) (by 0.42 L vs 0.20 L over baseline, P <.001), morning peak expiratory flow (by 49.94 L/min vs 11.68 L/min over baseline, P <. 001), and evening PEF (by 38.91 L/min vs 10.50 L/min over baseline, P <.001). Statistically significant differences between the two treatments in FEV(1) were noted after the first observation (week 4) and in morning and evening peak expiratory flow by week 2. Mean change in percentage of symptom-free days was greater with FP than with zafirlukast (28.5% of days vs 15.6% of days, P <.001) and FP significantly increased the percentage of rescue-free days by 40.4% of days compared with 24.2% of days with zafirlukast (P <.001). Treatment with FP significantly reduced albuterol use by 2.39 puffs per day compared with 1.45 puffs per day (P <.001) and increased the percentage of nights with no awakenings by 21.2% of nights compared with 8.0% of nights with zafirlukast (P <.001). CONCLUSION: The clinical effectiveness of a low dose of FP as first-line therapy in patients with persistent asthma who are symptomatic on beta(2)-agonists alone is superior to that of zafirlukast. SN - 0091-6749 UR - https://www.unboundmedicine.com/medline/citation/10856145/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S0091674900281736 DB - PRIME DP - Unbound Medicine ER -