RT Journal Article
SR Electronic
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
FD European Respiratory Society
SP p3952
VO 38
IS Suppl 55
A1 Laura Malagrinò
A1 Francesco Costa
A1 Lorenza Melosini
A1 Antonella Di Franco
A1 Giosuè Catapano
A1 Pierluigi Paggiaro
YR 2011
UL http://erj.ersjournals.com/content/38/Suppl_55/p3952.abstract
AB 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.