MONTELUKAST AS ADD-ON THERAPY TO INHALED BECLOMETHASONE IN PERSISTENT BRONCHIAL ASTHMA

Persistent Bronchial Asthma

Abstract

Objective: To evaluate the efficacy of Montelukast as add-on therapy in moderate persistent asthma with inadequate control on high dose inhaled beclomethasone.
Study Design: A quasi experimental study.
Place and Duration of Study: The study is carried out at the Combined Military Hospital Multan, from 1st Nov 2006 to 30th May 2007.
Patients and Methods: One hundred nonsmoking symptomatic asthmatics with one year history of moderate persistent bronchial asthma being treated with high dose inhaled beclomethasone dipropionate for at least 6 weeks before the study were selected as per inclusion criteria. Group-I (47 cases) was given inhaled beclomethasone (1000 μg daily in two divided doses) alone for 12 weeks. While Group-II (48 cases) received both inhaled beclomethasone (1000ug daily in two divided doses) and Montelukast Sodium 10 mg at bed time for 12 weeks. Seven-point global evaluation score and Pulmonary function test (PFTs) were done at 0, 6 and 12 weeks; and the need for use of rescue
2-agonist was also calculated in both groups.
Results: Mean age of patients was 29.30 years (SD±7.04) with 64.22% males. There was significant difference in episodes of dyspnea and wheeze among group I and group II at 6 weeks while all four parameters including cough and nocturnal awakenings were significantly less at 12 weeks in group II. Similar comparative improvement in mean FEV1 was seen at 12 weeks in group II. Combined therapy also reduced the use of rescue inhaled 2-agonist treatment.
Conclusion: Montelukast sodium as add-on therapy to high dose inhaled beclomethasone provides significant complementary clinical benefits in symptomatic moderate persistent asthmatics.