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Improvement of aspirin-intolerant asthma by montelukast, a leukotriene antagonist: a randomized, double-blind, placebo-controlled trial.
Am J Respir Crit Care Med. 2002 Jan 01; 165(1):9-14.AJ

Abstract

Leukotriene antagonists block the proinflammatory actions of leukotrienes (LT) and have been introduced as new treatments for asthma. Conventional therapy with glucocorticosteroids does not inhibit the biosynthesis of leukotrienes. We therefore tested whether addition of the leukotriene receptor antagonist montelukast was of therapeutic benefit in a group of aspirin-intolerant patients with asthma of whom 90% already were treated with moderate to high doses of glucocorticosteroids. Under double-blind conditions, 80 aspirin-intolerant patients with asthma were randomized to receive 4 wk oral treatment of either 10 mg of montelukast or placebo once daily at bedtime. Pulmonary function was measured as forced expiratory volume in 1 s (FEV(1)) once a week in the clinic and daily as morning and evening peak expiratory flow rate (PEFR). Asthma symptoms and use of rescue bronchodilator were also recorded daily. Asthma specific quality of life (QoL) was assessed before and after the treatments. The group receiving montelukast showed a remarkable improvement of their asthma, whereas the group given placebo showed no change. Thus, from equal baseline values, the mean difference between the groups over the 4-wk treatment period was 10.2% for FEV(1) and 28.0 L for morning PEFR (p for both < 0.001). The improved pulmonary function in the group receiving montelukast occurred at the same time as 27% less bronchodilator was used (p < 0.05), and it was associated with fewer asthma symptoms than in the group given placebo, including 1.3 nights more of sleep per week and 54% fewer asthma exacerbations (p < 0.05). There was also an improvement in asthma-specific QoL (p < 0.05). The therapeutic response to montelukast was consistent across patients with different baseline characteristics and did not correlate with baseline urinary LTE(4). Addition of a leukotriene receptor antagonist such as montelukast improves asthma in aspirin-intolerant patients over and above what can be achieved by glucocorticosteroids.

Authors+Show Affiliations

Experimental Asthma and Allergy Research, The National Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden. se.dahlen@imm.ki.seNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

11779723

Citation

Dahlén, Sven-Erik, et al. "Improvement of Aspirin-intolerant Asthma By Montelukast, a Leukotriene Antagonist: a Randomized, Double-blind, Placebo-controlled Trial." American Journal of Respiratory and Critical Care Medicine, vol. 165, no. 1, 2002, pp. 9-14.
Dahlén SE, Malmström K, Nizankowska E, et al. Improvement of aspirin-intolerant asthma by montelukast, a leukotriene antagonist: a randomized, double-blind, placebo-controlled trial. Am J Respir Crit Care Med. 2002;165(1):9-14.
Dahlén, S. E., Malmström, K., Nizankowska, E., Dahlén, B., Kuna, P., Kowalski, M., Lumry, W. R., Picado, C., Stevenson, D. D., Bousquet, J., Pauwels, R., Holgate, S. T., Shahane, A., Zhang, J., Reiss, T. F., & Szczeklik, A. (2002). Improvement of aspirin-intolerant asthma by montelukast, a leukotriene antagonist: a randomized, double-blind, placebo-controlled trial. American Journal of Respiratory and Critical Care Medicine, 165(1), 9-14.
Dahlén SE, et al. Improvement of Aspirin-intolerant Asthma By Montelukast, a Leukotriene Antagonist: a Randomized, Double-blind, Placebo-controlled Trial. Am J Respir Crit Care Med. 2002 Jan 1;165(1):9-14. PubMed PMID: 11779723.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Improvement of aspirin-intolerant asthma by montelukast, a leukotriene antagonist: a randomized, double-blind, placebo-controlled trial. AU - Dahlén,Sven-Erik, AU - Malmström,Kerstin, AU - Nizankowska,Ewa, AU - Dahlén,Barbro, AU - Kuna,Piotr, AU - Kowalski,Marek, AU - Lumry,William R, AU - Picado,César, AU - Stevenson,Donald D, AU - Bousquet,Jean, AU - Pauwels,Romain, AU - Holgate,Stephen T, AU - Shahane,Aditi, AU - Zhang,Ji, AU - Reiss,Theodore F, AU - Szczeklik,Andrew, PY - 2002/1/10/pubmed PY - 2002/2/14/medline PY - 2002/1/10/entrez SP - 9 EP - 14 JF - American journal of respiratory and critical care medicine JO - Am J Respir Crit Care Med VL - 165 IS - 1 N2 - Leukotriene antagonists block the proinflammatory actions of leukotrienes (LT) and have been introduced as new treatments for asthma. Conventional therapy with glucocorticosteroids does not inhibit the biosynthesis of leukotrienes. We therefore tested whether addition of the leukotriene receptor antagonist montelukast was of therapeutic benefit in a group of aspirin-intolerant patients with asthma of whom 90% already were treated with moderate to high doses of glucocorticosteroids. Under double-blind conditions, 80 aspirin-intolerant patients with asthma were randomized to receive 4 wk oral treatment of either 10 mg of montelukast or placebo once daily at bedtime. Pulmonary function was measured as forced expiratory volume in 1 s (FEV(1)) once a week in the clinic and daily as morning and evening peak expiratory flow rate (PEFR). Asthma symptoms and use of rescue bronchodilator were also recorded daily. Asthma specific quality of life (QoL) was assessed before and after the treatments. The group receiving montelukast showed a remarkable improvement of their asthma, whereas the group given placebo showed no change. Thus, from equal baseline values, the mean difference between the groups over the 4-wk treatment period was 10.2% for FEV(1) and 28.0 L for morning PEFR (p for both < 0.001). The improved pulmonary function in the group receiving montelukast occurred at the same time as 27% less bronchodilator was used (p < 0.05), and it was associated with fewer asthma symptoms than in the group given placebo, including 1.3 nights more of sleep per week and 54% fewer asthma exacerbations (p < 0.05). There was also an improvement in asthma-specific QoL (p < 0.05). The therapeutic response to montelukast was consistent across patients with different baseline characteristics and did not correlate with baseline urinary LTE(4). Addition of a leukotriene receptor antagonist such as montelukast improves asthma in aspirin-intolerant patients over and above what can be achieved by glucocorticosteroids. SN - 1073-449X UR - https://www.unboundmedicine.com/medline/citation/11779723/Improvement_of_aspirin_intolerant_asthma_by_montelukast_a_leukotriene_antagonist:_a_randomized_double_blind_placebo_controlled_trial_ L2 - https://www.atsjournals.org/doi/10.1164/ajrccm.165.1.2010080?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -