Addition of montelukast to low-dose inhaled corticosteroid leads to fewer exacerbations in older patients than medium-dose inhaled corticosteroid monotherapy

PRANA group

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Purpose: There have been few reports regarding the efficacy of antiasthmatics in older patients. To compare the efficacy of the addition of montelukast to low-dose inhaled budesonide (MON-400BUD) versus increasing the dose of inhaled steroid (800BUD) on asthma control in older asthmatics. Methods: A randomized, open-label, parallel-designed trial was conducted for 12 weeks. The primary endpoint was the rate of patients who reached "well-controlled asthma status" after the 12-week treatment period. Additionally, asthma exacerbations, sputum inflammatory cells, asthma control test (ACT) and physical functioning scale (PFS), and adverse reactions were monitored. Results: Twenty-four (36.9%) and 22 (34.9%) subjects in the MON-400BUD (n=65) and 800BUD (n=63) groups had well-controlled asthma at the end of the study, respectively. The numbers of asthma exacerbations requiring oral corticosteroid treatment (20 vs 9, respectively, P=0.036) and the development of sore throat (22 vs 11, respectively, P=0.045) were significantly higher in the 800BUD group than in the MON-400BUD group. Body mass index and changes in ACT, FEV1%, 6-min walk distance and PFS from baseline were all significant determinants for distinguishing subjects with well-controlled and partly controlled asthma from those with uncontrolled asthma (P<0.05) at the end of the study. Conclusions: The efficacy of 12-week treatment with MON- 400BUD in older asthmatics was comparable to that of 800BUD on asthma control but associated with reduced frequency of asthma exacerbations requiring oral steroids and sore throat events. Changes in ACT and PFS can be useful predictors of asthma control status in older patients.

Original languageEnglish
Pages (from-to)440-448
Number of pages9
JournalAllergy, Asthma and Immunology Research
Volume7
Issue number5
DOIs
Publication statusPublished - 2015 Jan 1

Fingerprint

montelukast
Adrenal Cortex Hormones
Asthma
Pharyngitis

Keywords

  • Asthma control
  • Asthma exacerbation
  • Inhaled corticosteroid
  • Leukotriene receptor antagonist
  • Older
  • Physical activity

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Pulmonary and Respiratory Medicine

Cite this

@article{7465da554a0e4541a83eccff01e4f82c,
title = "Addition of montelukast to low-dose inhaled corticosteroid leads to fewer exacerbations in older patients than medium-dose inhaled corticosteroid monotherapy",
abstract = "Purpose: There have been few reports regarding the efficacy of antiasthmatics in older patients. To compare the efficacy of the addition of montelukast to low-dose inhaled budesonide (MON-400BUD) versus increasing the dose of inhaled steroid (800BUD) on asthma control in older asthmatics. Methods: A randomized, open-label, parallel-designed trial was conducted for 12 weeks. The primary endpoint was the rate of patients who reached {"}well-controlled asthma status{"} after the 12-week treatment period. Additionally, asthma exacerbations, sputum inflammatory cells, asthma control test (ACT) and physical functioning scale (PFS), and adverse reactions were monitored. Results: Twenty-four (36.9{\%}) and 22 (34.9{\%}) subjects in the MON-400BUD (n=65) and 800BUD (n=63) groups had well-controlled asthma at the end of the study, respectively. The numbers of asthma exacerbations requiring oral corticosteroid treatment (20 vs 9, respectively, P=0.036) and the development of sore throat (22 vs 11, respectively, P=0.045) were significantly higher in the 800BUD group than in the MON-400BUD group. Body mass index and changes in ACT, FEV1{\%}, 6-min walk distance and PFS from baseline were all significant determinants for distinguishing subjects with well-controlled and partly controlled asthma from those with uncontrolled asthma (P<0.05) at the end of the study. Conclusions: The efficacy of 12-week treatment with MON- 400BUD in older asthmatics was comparable to that of 800BUD on asthma control but associated with reduced frequency of asthma exacerbations requiring oral steroids and sore throat events. Changes in ACT and PFS can be useful predictors of asthma control status in older patients.",
keywords = "Asthma control, Asthma exacerbation, Inhaled corticosteroid, Leukotriene receptor antagonist, Older, Physical activity",
author = "{PRANA group} and Ye, {Young Min} and Kim, {Sang Ha} and Hur, {Gyu Young} and Kim, {Joo Hee} and Park, {Jung Won} and Shim, {Jae Jeong} and Jung, {Ki Suck} and Lee, {Hyun Young} and Park, {Hae Sim}",
year = "2015",
month = "1",
day = "1",
doi = "10.4168/aair.2015.7.5.440",
language = "English",
volume = "7",
pages = "440--448",
journal = "Allergy, Asthma and Immunology Research",
issn = "2092-7355",
publisher = "Korean Academy of Asthma, Allergy and Clinical Immunology",
number = "5",

}

TY - JOUR

T1 - Addition of montelukast to low-dose inhaled corticosteroid leads to fewer exacerbations in older patients than medium-dose inhaled corticosteroid monotherapy

AU - PRANA group

AU - Ye, Young Min

AU - Kim, Sang Ha

AU - Hur, Gyu Young

AU - Kim, Joo Hee

AU - Park, Jung Won

AU - Shim, Jae Jeong

AU - Jung, Ki Suck

AU - Lee, Hyun Young

AU - Park, Hae Sim

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Purpose: There have been few reports regarding the efficacy of antiasthmatics in older patients. To compare the efficacy of the addition of montelukast to low-dose inhaled budesonide (MON-400BUD) versus increasing the dose of inhaled steroid (800BUD) on asthma control in older asthmatics. Methods: A randomized, open-label, parallel-designed trial was conducted for 12 weeks. The primary endpoint was the rate of patients who reached "well-controlled asthma status" after the 12-week treatment period. Additionally, asthma exacerbations, sputum inflammatory cells, asthma control test (ACT) and physical functioning scale (PFS), and adverse reactions were monitored. Results: Twenty-four (36.9%) and 22 (34.9%) subjects in the MON-400BUD (n=65) and 800BUD (n=63) groups had well-controlled asthma at the end of the study, respectively. The numbers of asthma exacerbations requiring oral corticosteroid treatment (20 vs 9, respectively, P=0.036) and the development of sore throat (22 vs 11, respectively, P=0.045) were significantly higher in the 800BUD group than in the MON-400BUD group. Body mass index and changes in ACT, FEV1%, 6-min walk distance and PFS from baseline were all significant determinants for distinguishing subjects with well-controlled and partly controlled asthma from those with uncontrolled asthma (P<0.05) at the end of the study. Conclusions: The efficacy of 12-week treatment with MON- 400BUD in older asthmatics was comparable to that of 800BUD on asthma control but associated with reduced frequency of asthma exacerbations requiring oral steroids and sore throat events. Changes in ACT and PFS can be useful predictors of asthma control status in older patients.

AB - Purpose: There have been few reports regarding the efficacy of antiasthmatics in older patients. To compare the efficacy of the addition of montelukast to low-dose inhaled budesonide (MON-400BUD) versus increasing the dose of inhaled steroid (800BUD) on asthma control in older asthmatics. Methods: A randomized, open-label, parallel-designed trial was conducted for 12 weeks. The primary endpoint was the rate of patients who reached "well-controlled asthma status" after the 12-week treatment period. Additionally, asthma exacerbations, sputum inflammatory cells, asthma control test (ACT) and physical functioning scale (PFS), and adverse reactions were monitored. Results: Twenty-four (36.9%) and 22 (34.9%) subjects in the MON-400BUD (n=65) and 800BUD (n=63) groups had well-controlled asthma at the end of the study, respectively. The numbers of asthma exacerbations requiring oral corticosteroid treatment (20 vs 9, respectively, P=0.036) and the development of sore throat (22 vs 11, respectively, P=0.045) were significantly higher in the 800BUD group than in the MON-400BUD group. Body mass index and changes in ACT, FEV1%, 6-min walk distance and PFS from baseline were all significant determinants for distinguishing subjects with well-controlled and partly controlled asthma from those with uncontrolled asthma (P<0.05) at the end of the study. Conclusions: The efficacy of 12-week treatment with MON- 400BUD in older asthmatics was comparable to that of 800BUD on asthma control but associated with reduced frequency of asthma exacerbations requiring oral steroids and sore throat events. Changes in ACT and PFS can be useful predictors of asthma control status in older patients.

KW - Asthma control

KW - Asthma exacerbation

KW - Inhaled corticosteroid

KW - Leukotriene receptor antagonist

KW - Older

KW - Physical activity

UR - http://www.scopus.com/inward/record.url?scp=84937416468&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84937416468&partnerID=8YFLogxK

U2 - 10.4168/aair.2015.7.5.440

DO - 10.4168/aair.2015.7.5.440

M3 - Article

VL - 7

SP - 440

EP - 448

JO - Allergy, Asthma and Immunology Research

JF - Allergy, Asthma and Immunology Research

SN - 2092-7355

IS - 5

ER -