[Aspirin induced asthma, urinary leukotriene E4 and zafirlukast].
OBJECTIVE
To evaluate the efficiency of zafirlukast in patients with aspirin-induced-asthma trough a measurement of VEF1, during the treatment and the symptoms daily reported. To evaluate the safety of treatment through a record of adversed events and laboratory and cabinet monitoring, to know the effect of zafirlukast on urine LTE4 level.


METHODS
It was an open, controlled, prospective, longitudinal, observational study. Twenty patients with aspirin-induced asthma were included and 10 extrinsic asthma patients as a group control. On the aspirin-induced asthma, age range was between 28-82 years old patients with an average of 55. 17 female and three male and group control with demographic similar features. All patients were included in a 30 days wash period avoiding anti-inflammatory medication like steroids, cromons, etc., on the initial phase treatment. A determination of blood cell count, transaminases, bilirubins, immunoglobulins, GAME, electrocardiogram, thorax study and LTE4 urine analysis was carried out. Twice a day 20 mg. zafirlukast dosis was administered to both groups, VO, during eight weeks. A symptoms report diary was given to each of the patients. A weekly and beginning sphirometric was carried out along the study to determine VEF1. Same laboratory and cabinet variables were determined on the final checking.


RESULTS
17 patients from the study group were analyzed and 10 from control group, an improvement of 12% average was reported on final VEF1, in comparison to the basal for both groups (p < .001) having this relation with the clinic improvement in the diary symptoms report. LTE4 urine levels diminished in similar form on both groups. This reduction was important (p < .001). Just three limited slight cephalalgia cases were reported (7.9%).


CONCLUSIONS
Asthmatic patients belonging to extrinsic or aspirin-induced asthma groups irrespectively showed an improvement from zafirlukast treatment on spirometric and clinic levels. No serious disadvantage was found associated to zafirlukast and side effects were slight after two months. In LTE4 level drop was found in urine, in possible relation with zafirlukast, interruption on the pulmonary chronic inflammatory process.
Orea Solano
Modesto
M
Hospital Regional Lic. Adolf López Mateos, ISSSTE, México, DF.
Flores Sandoval
Graciela
G
Machado C
Fidel
F
Romero
Humberto
H
Santos Argumedo
Leopoldo
L
D000328:Adult; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001241:Aspirin / Q000009:adverse effects*; D001249:Asthma / Q000139:chemically induced* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007211:Indoles; D017999:Leukotriene E4 / Q000652:urine*; D008137:Longitudinal Studies; D008297:Male; D048448:Phenylcarbamates; D011446:Prospective Studies; D013449:Sulfonamides; D014105:Tosyl Compounds / Q000627:therapeutic use*
D018927:Anti-Asthmatic Agents; D007211:Indoles; D048448:Phenylcarbamates; D013449:Sulfonamides; D014105:Tosyl Compounds; D017999:Leukotriene E4; D001241:Aspirin; C062735:zafirlukast