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Therapeutic effect of budesonide/formoterol, montelukast and N-acetylcysteine for bronchiolitis obliterans syndrome after hematopoietic stem cell transplantation.
Respir Res 2016; 17(1):63RR

Abstract

BACKGROUND

Bronchiolitis obliterans syndrome (BOS) after allogeneic hematopoietic stem cell transplantation (HSCT) is currently treated with systemic corticosteroids despite poor efficacy and side effects. This study investigated the therapeutic effect of budesonide/formoterol, montelukast and n-acetylcysteine, which are suggested as treatment options for BOS after HSCT.

METHODS

After diagnosis of BOS, 61 patients were treated with budesonide/formoterol, montelukast and n-acetylcysteine for 3 months. Pulmonary function test and COPD assessment test (CAT) were performed before and after the combination therapy. Therapeutic response was evaluated by changes in forced expiratory volume in 1 s (FEV1) or CAT score.

RESULTS

After 3 months of combination treatment, mean FEV1 increased by 220 mL (p < 0.001) and residual volume decreased by 200 mL (p =0 .005). Median CAT score also significantly decreased from 15.5 to 11.0 (p = 0.001). The overall response rate to combination therapy was 82 %. Comparing the no-response group and the response group, the forced vital capacity (% predicted) decline between pre-HSCT and BOS diagnosis was significantly greater in the response group (p = 0.036).

CONCLUSION

Combination treatment with budesonide/formoterol, montelukast and n-acetylcysteine significantly improved lung function and respiratory symptoms in patients with BOS after allogeneic HSCT without serious side effects.

Authors+Show Affiliations

Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.Division of Hematology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.Division of Hematology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.Division of Hematology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.Division of Hematology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. jwlee@catholic.ac.kr.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27229850

Citation

Kim, Sei Won, et al. "Therapeutic Effect of Budesonide/formoterol, Montelukast and N-acetylcysteine for Bronchiolitis Obliterans Syndrome After Hematopoietic Stem Cell Transplantation." Respiratory Research, vol. 17, no. 1, 2016, p. 63.
Kim SW, Rhee CK, Kim YJ, et al. Therapeutic effect of budesonide/formoterol, montelukast and N-acetylcysteine for bronchiolitis obliterans syndrome after hematopoietic stem cell transplantation. Respir Res. 2016;17(1):63.
Kim, S. W., Rhee, C. K., Kim, Y. J., Lee, S., Kim, H. J., & Lee, J. W. (2016). Therapeutic effect of budesonide/formoterol, montelukast and N-acetylcysteine for bronchiolitis obliterans syndrome after hematopoietic stem cell transplantation. Respiratory Research, 17(1), p. 63. doi:10.1186/s12931-016-0380-1.
Kim SW, et al. Therapeutic Effect of Budesonide/formoterol, Montelukast and N-acetylcysteine for Bronchiolitis Obliterans Syndrome After Hematopoietic Stem Cell Transplantation. Respir Res. 2016 05 26;17(1):63. PubMed PMID: 27229850.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Therapeutic effect of budesonide/formoterol, montelukast and N-acetylcysteine for bronchiolitis obliterans syndrome after hematopoietic stem cell transplantation. AU - Kim,Sei Won, AU - Rhee,Chin Kook, AU - Kim,Yoo Jin, AU - Lee,Seok, AU - Kim,Hee Je, AU - Lee,Jong Wook, Y1 - 2016/05/26/ PY - 2015/12/04/received PY - 2016/05/18/accepted PY - 2016/5/28/entrez PY - 2016/5/28/pubmed PY - 2017/12/2/medline KW - Bronchiolitis obliterans syndrome KW - Inhaled corticosteroid KW - Long-acting β2-adrenergic agonist KW - Montelukast KW - n-acetylcysteine SP - 63 EP - 63 JF - Respiratory research JO - Respir. Res. VL - 17 IS - 1 N2 - BACKGROUND: Bronchiolitis obliterans syndrome (BOS) after allogeneic hematopoietic stem cell transplantation (HSCT) is currently treated with systemic corticosteroids despite poor efficacy and side effects. This study investigated the therapeutic effect of budesonide/formoterol, montelukast and n-acetylcysteine, which are suggested as treatment options for BOS after HSCT. METHODS: After diagnosis of BOS, 61 patients were treated with budesonide/formoterol, montelukast and n-acetylcysteine for 3 months. Pulmonary function test and COPD assessment test (CAT) were performed before and after the combination therapy. Therapeutic response was evaluated by changes in forced expiratory volume in 1 s (FEV1) or CAT score. RESULTS: After 3 months of combination treatment, mean FEV1 increased by 220 mL (p < 0.001) and residual volume decreased by 200 mL (p =0 .005). Median CAT score also significantly decreased from 15.5 to 11.0 (p = 0.001). The overall response rate to combination therapy was 82 %. Comparing the no-response group and the response group, the forced vital capacity (% predicted) decline between pre-HSCT and BOS diagnosis was significantly greater in the response group (p = 0.036). CONCLUSION: Combination treatment with budesonide/formoterol, montelukast and n-acetylcysteine significantly improved lung function and respiratory symptoms in patients with BOS after allogeneic HSCT without serious side effects. SN - 1465-993X UR - https://www.unboundmedicine.com/medline/citation/27229850/Therapeutic_effect_of_budesonide/formoterol_montelukast_and_N_acetylcysteine_for_bronchiolitis_obliterans_syndrome_after_hematopoietic_stem_cell_transplantation_ L2 - https://respiratory-research.biomedcentral.com/articles/10.1186/s12931-016-0380-1 DB - PRIME DP - Unbound Medicine ER -