title: Comparison of oral montelukast with oral zileuton in acute asthma: A randomized, double-blind, placebo-controlled study.
abstract: BACKGROUND
  Leukotriene modifiers have an established role in the management of chronic asthma but their role in acute asthma is still under evaluation.
  
  
  OBJECTIVE
  To study and compare the effects of oral montelukast with oral zileuton in acute asthma.
  
  
  METHODS
  This study included 120 asthmatics and was conducted from September 2012 to March 2014. Patients were randomized into three different groups to receive montelukast or zileuton or placebo in addition to standard treatment for asthma exacerbation. Peak expiratory flow rate (PEFR) values, details of rescue medication and vital signs were recorded at 6 h, 12 h, 24 h, and 48 h of drug or placebo administration and at discharge. Additional recording was done in the morning (8-10 am) following admission. The primary endpoint was the mean PEFR of each group at these time points; the secondary end point being the need for rescue medications.
  
  
  RESULTS
  The mean PEFR recordings of the three study groups - placebo, montelukast, and zileuton - respectively, at various time points were as follows: at 6 h (223.25 ± 90.40, 199.00 ± 82.52, 233.75 ± 84.05; P = 0.240); at 12 h (271.00 ± 109.38, 251.50 ± 101.44, 309.50 ± 129.63; P = 0.048); at 24 h (288.25 ± 114.26, 269.00 ± 107.51, 324.50 ± 127.88; P = 0.080); and at 48 h (295.00 ± 114.80, 293.50 ± 113.24, 344.75 ± 119.91; P = 0.015); discharge (305.00 ± 118.56, 305.25 ± 119.51, 361.25 ± 119.70; P = 0.010). The mean PEFR for the three study groups at 8-10 am on the morning following admission was 268.75 ± 111.43, 252.50 ± 99.99, 306.75 ± 114.44; P = 0.047. Total rescue doses needed were 10, 1, and 0, respectively (P = 0.049).
  
  
  CONCLUSIONS
  Zileuton is better than montelukast as an additional drug in acute asthma and results in significant improvement in lung function, and reduction in the need for rescue medications.
authors.affiliation: Department of Pulmonary Medicine, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.
authors.forename: Rahul
authors.initials: R
authors.lastname: Magazine
authors.affiliation: Department of Pulmonary Medicine, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.
authors.forename: Hameed Aboobackar
authors.initials: HA
authors.lastname: Shahul
authors.affiliation: Department of Pharmacology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.
authors.forename: Bharti
authors.initials: B
authors.lastname: Chogtu
authors.affiliation: Department of Community Medicine, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.
authors.forename: Asha
authors.initials: A
authors.lastname: Kamath
keywords: Acute asthma; montelukast; zileuton