TY - JOUR T1 - Montelukast as add-on therapy may improve some indices of small airways involvement in uncontrolled asthmatics JF - European Respiratory Journal JO - Eur Respir J VL - 38 IS - Suppl 55 SP - p3952 AU - Laura Malagrinò AU - Francesco Costa AU - Lorenza Melosini AU - Antonella Di Franco AU - Giosuè Catapano AU - Pierluigi Paggiaro Y1 - 2011/09/01 UR - http://erj.ersjournals.com/content/38/Suppl_55/p3952.abstract N2 - Background: Several studies suggest an involvement of small airways in asthma that may contribute to poor disease control.Aim: To assess whether montelukast improves indices of small airways involvement and clinical outcomes in asthmatics under regular therapy with medium-high doses of inhaled corticosteroids and long-acting β2-agonist.Subjects and methods: 24 nonsmoker asthmatics underwent, at baseline and after one-month open label therapy with montelukast: FEV1, Single Breath Nitrogen Whashout for phase III slope (DN2); multiple flows exhaled nitric oxide (NO); eosinophils in sputum (Eo%); alveolar-arterial differences of respiratory gases (AaDO2, aADCO2); asthma control obtained by symptoms (S) and variability of peak expiration flow (ΔPEF) monitoring.Results: Patients were divided in controlled (n=7 well controlled, n=10 partially controlled) and non-controlled (n=7), according to GINA guidelines. After one-month therapy with montelukast: a) in controlled group, therapy significantly reduced ΔPEF (18.2±9.1 vs 13.1±8.1, p=0.007); b) in non-controlled group, therapy significantly reduced only AaDO2 (32.1±7.9 vs 25.8±7.7 mmHg, p=0.034). Patients were also divided in other two groups according to the number of abnormal indices of small airways involvement (DN2, CaNO and AaDO2) at baseline: 0-1 vs 2-3 abnormalities. Montelukast reduced ΔPEF (21.8±7.8 vs 17.3±11.2, p=0.001) only in patients with 2-3 abnormalities in small airway indices.Conclusions: Montelukast might improve both functional and clinical indices of small airways involvement, in controlled and non-controlled asthmatics and this might be associated with some effects on small airways. ER -