@article {Malagrin{\`o}p3952, author = {Laura Malagrin{\`o} and Francesco Costa and Lorenza Melosini and Antonella Di Franco and Giosu{\`e} Catapano and Pierluigi Paggiaro}, title = {Montelukast as add-on therapy may improve some indices of small airways involvement in uncontrolled asthmatics}, volume = {38}, number = {Suppl 55}, elocation-id = {p3952}, year = {2011}, publisher = {European Respiratory Society}, abstract = {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{\textpm}9.1 vs 13.1{\textpm}8.1, p=0.007); b) in non-controlled group, therapy significantly reduced only AaDO2 (32.1{\textpm}7.9 vs 25.8{\textpm}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{\textpm}7.8 vs 17.3{\textpm}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.}, issn = {0903-1936}, URL = {https://erj.ersjournals.com/content/38/Suppl_55/p3952}, eprint = {https://erj.ersjournals.com/content}, journal = {European Respiratory Journal} }