title: Comparison of add-on therapy to inhaled fluticasone propionate in children with asthma: residual volume and exhaled nitric oxide as outcome measures.
abstract: The purpose of this study was to evaluate changes in lung function and fractional exhaled nitric oxide (FeNO) in children with mild to moderate persistent asthma treated with low-dose inhaled steroids but still manifesting significantly increased residual volume (RV). This was a crossover study evaluating lung function and FeNO before and after a 2-week crossover therapy period by adding either montelukast or salmeterol to inhaled fluticasone propionate in 12 children with asthma. Salmeterol increased forced expiratory volume at 1 second (FEV(1)) and decreased RV without effects on eNO. Addition of montelukast produced a statistically significant decrease both for RV (from 191.7 +/- 60.8% to 132.4 +/- 36.1%; p = 0.03) and for eNO (from 14.0 +/- 6.3 ppb to 8. 5+/- 5.0 ppb; p < 0.01). No effect was observed for the montelukast treatment period in FEV(1) and forced expiratory flow at 25-75%. Add-on therapy may reduce RV and decrease levels of FeNO, leading to consideration of a possible anti-inflammatory additive effect that could improve the control of the disease.
authors.affiliation: Servizio di Allergologia e Fisiopatologia Respiratoria Infantile, Clinica Pediatrica Universita' di Chieti, Italy.
authors.forename: Marcello
authors.initials: M
authors.lastname: Verini
authors.forename: Diego G
authors.initials: DG
authors.lastname: Peroni
authors.forename: Giorgio L
authors.initials: GL
authors.lastname: Piacentini
authors.forename: Angiolina
authors.initials: A
authors.lastname: Nicodemo
authors.forename: Nadia
authors.initials: N
authors.lastname: Rossi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Bodini
authors.forename: Francesco
authors.initials: F
authors.lastname: Chiarelli
authors.forename: Attilio L
authors.initials: AL
authors.lastname: Boner
mesh_terms: D000085:Acetates / Q000008:administration & dosage / Q000627:therapeutic use*; D000280:Administration, Inhalation; D000293:Adolescent; D000420:Albuterol / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000730:Androstadienes / Q000008:administration & dosage / Q000627:therapeutic use*; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002648:Child; D018592:Cross-Over Studies; D003521:Cyclopropanes; D004359:Drug Therapy, Combination; D000068298:Fluticasone; D006801:Humans; D009569:Nitric Oxide / Q000032:analysis; D011804:Quinolines / Q000008:administration & dosage / Q000627:therapeutic use*; D012129:Respiratory Function Tests; D000068299:Salmeterol Xinafoate; D016037:Single-Blind Method; D013147:Spirometry; D013440:Sulfides
chemical_list: D000085:Acetates; D000730:Androstadienes; D018927:Anti-Asthmatic Agents; D001993:Bronchodilator Agents; D003521:Cyclopropanes; D011804:Quinolines; D013440:Sulfides; D009569:Nitric Oxide; D000068299:Salmeterol Xinafoate; D000068298:Fluticasone; C093875:montelukast; D000420:Albuterol