Abstract
Background: Montelukast added to inhaled corticosteroids (ICS) has been demonstrated to relieve asthma symptoms and control airway inflammation equal to double dose ICS. However, the clinical efficacy of montelukast as add-on therapy to ICS has not been reported in nonasthmatic eosinophilic bronchitis (NAEB).
Objectives: Whether add-on therapy with montelukast to inhaled budesonide would equal double dose inhaled budesonide in alleviating cough and airway eosinophilia in adult patients with steroid-naïve NAEB was studied, the primary endpoints were changes of cough visual analogue score (CVAS) and eosinophil ratio in induced sputum (EOS) during treatment.
Methods: 26 nonsmoking subjects were randomized to receive either montelukast 10mg qd plus budesonide turbuhalor 200 μg bid (MONT-BUD) or budesonide turbuhalor 400 μg bid (BUD) for 4 weeks. CVAS, EOS at baseline, 1 week, 2 week and 4 week after treatment were measured. Adverse reactions were monitored.
Results: The two groups were comparable in age, median duration of cough and baseline CVAS. Median baseline EOS of MONT-BUD and BUD was 11.8% and 22.7%. Improvement of CVAS was more profound in MONT-BUD. In both groups EOS was normalized in both groups at end of therapy with similar EOS reduction at all time points. Both regimens were well tolerated.
Conclusions: This study demonstrated that the addition of montelukast to inhaled budesonide was an effective and well tolerated alternative to inhaled budesonide with resolution of airway eosinophilia and more remarkable reduction of cough in NAEB.
- © 2011 ERS
