Comparative efficacy of once-daily therapy with inhaled corticosteroid, leukotriene antagonist or sustained-release theophylline in patients with mild persistent asthma.
The purpose of this study was to compare the efficacy and safety of the inhaled budesonide, sustained-release theophylline and montelukast, a leukotriene receptor antagonist, in patients with mild persistent asthma. In this single-center, randomized, parallel-group study that not designed blindly and placebo-controlled manner, 74 patients with mild persistent asthma were treated with either inhaled budesonide 400 microg once daily, oral montelukast 10 mg once daily, or sustained-release theophylline 400 mg once daily for 3 months. In all three treatment groups, improvements were attained in overall asthma control. Asthma symptom scores and supplemental beta2-agonist use were quite the same in all three treatment groups (P>0.05). Although inhaled budesonide group resulted in significantly greater improvements compared with the other two groups in the lung functions (P<0.05), the changes in FEV1 and PEF are within the baseline variability and there was no statistically significant difference among the groups when analyzed by treatment month (P>0.05). Exacerbations of asthma were experienced by 16% of the patients in the montekulast group, by 12.5% of the patients in the theophylline group, and by none of the patients in the budesonide group. The adverse event in each of the three groups was 12%, 16% and 16.7%, respectively. It is concluded that the most important clinical parameters do not point that one of the treatments is more effective than others. Treatment with inhaled corticosteroid is preferred, but sustained-release theophylline and leukotriene antagonists are alternative controller medications in mild persistent asthma.
Yurdakul
Ahmet Selim
AS
Atatürk Chest Disease and Thoracic Surgery Education and Research Hospital, Balkiraz mah, Saraycik Sok, Parlemento sit, B Blok, No: 20/53, Ankara, Turkey. ahmetselimyurdakul@hotmail.com
Taci
Nevin
N
Eren
Ayşegül
A
Sipit
Tuğrul
T
D000085:Acetates / Q000008:administration & dosage* / Q000009:adverse effects; D000280:Administration, Inhalation; D058672:Adrenergic beta-2 Receptor Antagonists; D000328:Adult; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage*; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D001993:Bronchodilator Agents / Q000008:administration & dosage; D019819:Budesonide / Q000008:administration & dosage* / Q000009:adverse effects; D003521:Cyclopropanes; D003692:Delayed-Action Preparations; D004311:Double-Blind Method; D005260:Female; D005541:Forced Expiratory Volume / Q000187:drug effects; D006801:Humans; D020024:Leukotriene Antagonists / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D010366:Peak Expiratory Flow Rate / Q000187:drug effects; D011804:Quinolines / Q000008:administration & dosage* / Q000009:adverse effects; D013440:Sulfides; D013806:Theophylline / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome
D000085:Acetates; D058672:Adrenergic beta-2 Receptor Antagonists; D018927:Anti-Asthmatic Agents; D001993:Bronchodilator Agents; D003521:Cyclopropanes; D003692:Delayed-Action Preparations; D020024:Leukotriene Antagonists; D011804:Quinolines; D013440:Sulfides; D019819:Budesonide; D013806:Theophylline; C093875:montelukast