title: [Pranlukast allows reduction of inhaled steroid dose without deterioration in lung function in adult asthmatics].
abstract: We undertook a community based case-control study to measure the effect of pranlukast on the reduction of inhaled steroid in adult asthmatics. Forty-one adults completed a run-in period of 4 weeks on 800 microgram of beclomethasone dipropionate (BDP) documenting twice daily peak expiratory flow (PEF) and symptom score and therapeutic score on a standard diary. Forced expiratory volume in one second (FEV1.0), V50, V25 was measured once during the run-in period. Patients were then randomized to receive either pranlukast with 400 microgram of BDP or 400 microgram alone for 8 weeks. There was no difference in the symptom score and therapeutic between the two groups at any time point. However, morning and evening % PEF run-in expressed as a % of the PEF average during the run-in period was significantly lower at 8 weeks in the groups without pranlukast. There were subjects in the group without pranlukast (35.3%) compared to those with (20.8%) who had a 10% or more reduction in % PEF from the run-in period. The patients with an FEV1.0 < 80% predicted who were randomized to the control group were more likely (5 of 7) to have a fall in % PEF run-in and those randomized to received pranlukast were less likely to have a fall in % PEF run-in though this was not significant (2 of 6). In this study, pranlukast has demonstrated steroid sparing effect. Severe asthmatics (FEV1.0 < 80%) who deteriorate after reduction of inhaled steroid may benefit most from pranlukast. Larger studies are now required to explore this important effect.
authors.affiliation: Third Department of Internal Medicine, Faculty of Medicine, Tottori University.
authors.forename: K
authors.initials: K
authors.lastname: Tomita
authors.forename: K
authors.initials: K
authors.lastname: Hashimoto
authors.forename: S
authors.initials: S
authors.lastname: Matsumoto
authors.forename: N
authors.initials: N
authors.lastname: Nakamoto
authors.forename: H
authors.initials: H
authors.lastname: Tokuyasu
authors.forename: A
authors.initials: A
authors.lastname: Yamasaki
authors.forename: H
authors.initials: H
authors.lastname: Yajima
authors.forename: T
authors.initials: T
authors.lastname: Sasaki
authors.forename: Y
authors.initials: Y
authors.lastname: Kawasaki
authors.forename: K
authors.initials: K
authors.lastname: Fukutani
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage*; D001249:Asthma / Q000188:drug therapy*; D001507:Beclomethasone / Q000008:administration & dosage*; D016022:Case-Control Studies; D002867:Chromones / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D020024:Leukotriene Antagonists / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D012129:Respiratory Function Tests
chemical_list: D018927:Anti-Asthmatic Agents; D002867:Chromones; D020024:Leukotriene Antagonists; D001507:Beclomethasone; C047681:pranlukast