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Differential effects of fluticasone and montelukast on allergen-induced asthma.
Allergy. 2005 Jan; 60(1):65-70.A

Abstract

Early asthmatic responses (EAR) and late asthmatic responses (LAR) to allergen are induced by the local release of a series of bronchoconstrictor mediators, including leukotrienes and histamine. Both anti-leukotrienes and other anti-asthma drugs, such as inhaled glucocorticoids, have been shown to reduce both EAR and LAR. The aim of the present study was to directly compare the effects of regular treatment with an oral anti-leukotriene, montelukast (Mont; 10 mg once daily, for 8 days), and an inhaled glucocorticoid [fluticasone propionate (FP) 250 microg twice daily for 8 days] on the EAR and LAR to an inhaled allergen challenge. Patients with a documented EAR and LAR at a screening visit were randomized to these treatments, or placebo, in a double-blind, double-dummy, crossover fashion. Allergen challenge at a dose causing both an EAR and LAR was given on the eighth day of treatment. The maximum fall in FEV1 during the EAR was 17.8% during placebo treatment, 8.3% during Mont and 16.3% during FP (P <0.05 for Mont vs placebo). The maximum fall during the EAR was 13.8% during placebo treatment, 11.8% during Mont and 2% during FP treatment (P <0.05 for FP vs placebo and FP vs Mont). PC20 methacholine was significantly higher 24 h after allergen challenge during FP-treatment compared with Mont (P <0.05). Both montelukast and fluticasone reduced the relative amount of sputum eosinophils after allergen compared with placebo treatment. This study shows that anti-leukotrienes are effective to attenuate the EAR, whereas inhaled glucocorticoids are more effective than anti-leukotrienes in attenuating the EARs and improves bronchial hyperresponsiveness to a greater extent. In conclusion, inhaled glucocorticoids have overall greater efficacy than oral anti-leukotrienes to attenuate allergen-induced airway responses in mild asthmatic patients.

Authors+Show Affiliations

Section of Allergy, The Lung Pharmacology Group, Department of Respiratory Medicine and Allergology, Göteborg University, Gothenburg, Sweden.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

15575933

Citation

Palmqvist, M, et al. "Differential Effects of Fluticasone and Montelukast On Allergen-induced Asthma." Allergy, vol. 60, no. 1, 2005, pp. 65-70.
Palmqvist M, Bruce C, Sjöstrand M, et al. Differential effects of fluticasone and montelukast on allergen-induced asthma. Allergy. 2005;60(1):65-70.
Palmqvist, M., Bruce, C., Sjöstrand, M., Arvidsson, P., & Lötvall, J. (2005). Differential effects of fluticasone and montelukast on allergen-induced asthma. Allergy, 60(1), 65-70.
Palmqvist M, et al. Differential Effects of Fluticasone and Montelukast On Allergen-induced Asthma. Allergy. 2005;60(1):65-70. PubMed PMID: 15575933.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Differential effects of fluticasone and montelukast on allergen-induced asthma. AU - Palmqvist,M, AU - Bruce,C, AU - Sjöstrand,M, AU - Arvidsson,P, AU - Lötvall,J, PY - 2004/12/4/pubmed PY - 2005/4/6/medline PY - 2004/12/4/entrez SP - 65 EP - 70 JF - Allergy JO - Allergy VL - 60 IS - 1 N2 - Early asthmatic responses (EAR) and late asthmatic responses (LAR) to allergen are induced by the local release of a series of bronchoconstrictor mediators, including leukotrienes and histamine. Both anti-leukotrienes and other anti-asthma drugs, such as inhaled glucocorticoids, have been shown to reduce both EAR and LAR. The aim of the present study was to directly compare the effects of regular treatment with an oral anti-leukotriene, montelukast (Mont; 10 mg once daily, for 8 days), and an inhaled glucocorticoid [fluticasone propionate (FP) 250 microg twice daily for 8 days] on the EAR and LAR to an inhaled allergen challenge. Patients with a documented EAR and LAR at a screening visit were randomized to these treatments, or placebo, in a double-blind, double-dummy, crossover fashion. Allergen challenge at a dose causing both an EAR and LAR was given on the eighth day of treatment. The maximum fall in FEV1 during the EAR was 17.8% during placebo treatment, 8.3% during Mont and 16.3% during FP (P <0.05 for Mont vs placebo). The maximum fall during the EAR was 13.8% during placebo treatment, 11.8% during Mont and 2% during FP treatment (P <0.05 for FP vs placebo and FP vs Mont). PC20 methacholine was significantly higher 24 h after allergen challenge during FP-treatment compared with Mont (P <0.05). Both montelukast and fluticasone reduced the relative amount of sputum eosinophils after allergen compared with placebo treatment. This study shows that anti-leukotrienes are effective to attenuate the EAR, whereas inhaled glucocorticoids are more effective than anti-leukotrienes in attenuating the EARs and improves bronchial hyperresponsiveness to a greater extent. In conclusion, inhaled glucocorticoids have overall greater efficacy than oral anti-leukotrienes to attenuate allergen-induced airway responses in mild asthmatic patients. SN - 0105-4538 UR - https://www.unboundmedicine.com/medline/citation/15575933/Differential_effects_of_fluticasone_and_montelukast_on_allergen_induced_asthma_ L2 - https://doi.org/10.1111/j.1398-9995.2005.00633.x DB - PRIME DP - Unbound Medicine ER -