Ontology highlight
ABSTRACT: Rationale
Long-acting beta-agonists (LABAs) and inhaled corticosteroids administered together appear to be complementary in terms of effects on asthma control. The elements of asthma control achieved by LABAs (improved lung function) and leukotriene receptor antagonists (LTRAs; protection against exacerbations) may be complementary as well.Objective
We sought to determine whether the combination of the LTRA montelukast and the LABA salmeterol could provide an effective therapeutic strategy for asthma.Methods and measurements
In a randomized, placebo-controlled, crossover study of 192 subjects with moderate asthma, we compared the clinical efficacy of regular treatment over 14 weeks with the combination of montelukast and salmeterol to that with the combination of beclomethasone and salmeterol in moderate asthma. The primary efficacy outcome was time to treatment failure.Main results
Three months after the randomization of the last subject, the Data and Safety Monitoring Board determined that the primary research question had been answered and terminated the trial. The combination of montelukast and salmeterol was inferior to the combination of beclomethasone and salmeterol as judged by protection against asthma treatment failures (p = 0.0008), lung function (26 L/min difference in a.m. peak expiratory flow rate, p = 0.011), asthma control score (0.22 difference in Asthma Control Questionnaire score, p = 0.038), and markers of inflammation and airway reactivity.Conclusions
Patients with moderate asthma similar to those we studied should not substitute the combination of an LTRA and an LABA for the combination of inhaled corticosteroid and an LABA.
SUBMITTER: Deykin A
PROVIDER: S-EPMC1899264 | biostudies-literature | 2007 Feb
REPOSITORIES: biostudies-literature
Deykin Aaron A Wechsler Michael E ME Boushey Homer A HA Chinchilli Vernon M VM Kunselman Susan J SJ Craig Timothy J TJ DiMango Emily E Fahy John V JV Kraft Monica M Leone Frank F Lazarus Stephen C SC Lemanske Robert F RF Martin Richard J RJ Pesola Gene R GR Peters Stephen P SP Sorkness Christine A CA Szefler Stanley J SJ Israel Elliot E
American journal of respiratory and critical care medicine 20060914 3
<h4>Rationale</h4>Long-acting beta-agonists (LABAs) and inhaled corticosteroids administered together appear to be complementary in terms of effects on asthma control. The elements of asthma control achieved by LABAs (improved lung function) and leukotriene receptor antagonists (LTRAs; protection against exacerbations) may be complementary as well.<h4>Objective</h4>We sought to determine whether the combination of the LTRA montelukast and the LABA salmeterol could provide an effective therapeuti ...[more]