Montelukast reduces airway eosinophilic inflammation in asthma: a randomized, controlled trial
Leukotrienes are pro‐inflammatory mediators which may contribute to tissue, sputum, and blood eosinophilia seen in allergic and inflammatory diseases, including asthma. Montelukast is a cysteinyl leukotriene1 (CysLT1) receptor antagonist which improves asthma control; the aim of this study was to in...
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| Veröffentlicht in: | The European respiratory journal 1999-07, Vol.14 (1), p.12-18 |
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| creator | Pizzichini, E Leff, JA Reiss, TF Hendeles, L Boulet, LP Wei, LX Efthimiadis, AE Zhang, J Hargreave, FE |
| description | Leukotrienes are pro‐inflammatory mediators which may contribute to tissue, sputum, and blood eosinophilia seen in allergic and inflammatory diseases, including asthma. Montelukast is a cysteinyl leukotriene1 (CysLT1) receptor antagonist which improves asthma control; the aim of this study was to investigate its effect on induced sputum eosinophils.
Montelukast 10 mg (n=19) or placebo (n=21) were administered orally once in the evening for 4 weeks to 40 chronic adult asthmatic patients, aged 19–64 yrs, in a double‐blind, randomized, parallel group study. Patients were included if, at prestudy, they had >5% sputum eosinophils, symptomatic asthma with a forced expiratory volume in one second ≥65% of the predicted value and were being treated only with “as needed” inhaled β2‐agonists. In addition to sputum eosinophils, blood eosinophils and clinical endpoints were also assessed.
Four weeks of montelukast treatment decreased sputum eosinophils from 7.5% to 3.9% (3.6% decrease, 95% confidence interval (CI) ‐16.6–0.4). In contrast, placebo treatment was associated with an increase in sputum eosinophils from 14.5% to 17.9% (3.4% increase, 95% CI ‐3.5–9.8). The least squares mean difference between groups (‐11.3%, 95% CI ‐21.1–‐1.4) was significant (p=0.026). Compared with placebo, montelukast significantly reduced blood eosinophils (p=0.009), asthma symptoms (p=0.001) and β2‐agonist use (p |
| doi_str_mv | 10.1034/j.1399-3003.1999.14a04.x |
| format | Article |
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Montelukast 10 mg (n=19) or placebo (n=21) were administered orally once in the evening for 4 weeks to 40 chronic adult asthmatic patients, aged 19–64 yrs, in a double‐blind, randomized, parallel group study. Patients were included if, at prestudy, they had >5% sputum eosinophils, symptomatic asthma with a forced expiratory volume in one second ≥65% of the predicted value and were being treated only with “as needed” inhaled β2‐agonists. In addition to sputum eosinophils, blood eosinophils and clinical endpoints were also assessed.
Four weeks of montelukast treatment decreased sputum eosinophils from 7.5% to 3.9% (3.6% decrease, 95% confidence interval (CI) ‐16.6–0.4). In contrast, placebo treatment was associated with an increase in sputum eosinophils from 14.5% to 17.9% (3.4% increase, 95% CI ‐3.5–9.8). The least squares mean difference between groups (‐11.3%, 95% CI ‐21.1–‐1.4) was significant (p=0.026). Compared with placebo, montelukast significantly reduced blood eosinophils (p=0.009), asthma symptoms (p=0.001) and β2‐agonist use (p<0.001) while significantly increasing morning peak expiratory flow (p=0.001). Montelukast was generally well tolerated in this study, with a safety profile similar to the placebo.
These results demonstrate that montelukast decreases airway eosinophilic inflammation in addition to improving clinical parameters. Its efficacy in the treatment of chronic asthma may be due, in part, to the effect on airway inflammation.</description><identifier>ISSN: 0903-1936</identifier><identifier>EISSN: 1399-3003</identifier><identifier>DOI: 10.1034/j.1399-3003.1999.14a04.x</identifier><identifier>PMID: 10489822</identifier><language>eng</language><publisher>Oxford, UK: Eur Respiratory Soc</publisher><subject>Acetates - therapeutic use ; Adult ; Airway inflammation ; asthma ; Asthma - complications ; Asthma - drug therapy ; Asthma - physiopathology ; Biological and medical sciences ; cysteinyl leukotriene receptor antagonists ; Double-Blind Method ; Eosinophils - drug effects ; Female ; Humans ; Leukocyte Count - drug effects ; Leukotriene Antagonists - therapeutic use ; Male ; Medical sciences ; Middle Aged ; montelukast ; Pharmacology. Drug treatments ; Pulmonary Eosinophilia - complications ; Pulmonary Eosinophilia - drug therapy ; Pulmonary Eosinophilia - physiopathology ; Quinolines - therapeutic use ; Respiratory Function Tests ; Respiratory system ; Respiratory Tract Diseases - complications ; Respiratory Tract Diseases - drug therapy ; Respiratory Tract Diseases - pathology ; Safety ; Sputum - cytology ; Sputum - drug effects ; sputum eosinophils ; Treatment Outcome</subject><ispartof>The European respiratory journal, 1999-07, Vol.14 (1), p.12-18</ispartof><rights>1999 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5404-ac280029998c2c94241d95cbb83d573c417735ffa098dff6098605126aeb5af03</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1034%2Fj.1399-3003.1999.14a04.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45551</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1928435$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10489822$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pizzichini, E</creatorcontrib><creatorcontrib>Leff, JA</creatorcontrib><creatorcontrib>Reiss, TF</creatorcontrib><creatorcontrib>Hendeles, L</creatorcontrib><creatorcontrib>Boulet, LP</creatorcontrib><creatorcontrib>Wei, LX</creatorcontrib><creatorcontrib>Efthimiadis, AE</creatorcontrib><creatorcontrib>Zhang, J</creatorcontrib><creatorcontrib>Hargreave, FE</creatorcontrib><title>Montelukast reduces airway eosinophilic inflammation in asthma: a randomized, controlled trial</title><title>The European respiratory journal</title><addtitle>Eur Respir J</addtitle><description>Leukotrienes are pro‐inflammatory mediators which may contribute to tissue, sputum, and blood eosinophilia seen in allergic and inflammatory diseases, including asthma. Montelukast is a cysteinyl leukotriene1 (CysLT1) receptor antagonist which improves asthma control; the aim of this study was to investigate its effect on induced sputum eosinophils.
Montelukast 10 mg (n=19) or placebo (n=21) were administered orally once in the evening for 4 weeks to 40 chronic adult asthmatic patients, aged 19–64 yrs, in a double‐blind, randomized, parallel group study. Patients were included if, at prestudy, they had >5% sputum eosinophils, symptomatic asthma with a forced expiratory volume in one second ≥65% of the predicted value and were being treated only with “as needed” inhaled β2‐agonists. In addition to sputum eosinophils, blood eosinophils and clinical endpoints were also assessed.
Four weeks of montelukast treatment decreased sputum eosinophils from 7.5% to 3.9% (3.6% decrease, 95% confidence interval (CI) ‐16.6–0.4). In contrast, placebo treatment was associated with an increase in sputum eosinophils from 14.5% to 17.9% (3.4% increase, 95% CI ‐3.5–9.8). The least squares mean difference between groups (‐11.3%, 95% CI ‐21.1–‐1.4) was significant (p=0.026). Compared with placebo, montelukast significantly reduced blood eosinophils (p=0.009), asthma symptoms (p=0.001) and β2‐agonist use (p<0.001) while significantly increasing morning peak expiratory flow (p=0.001). Montelukast was generally well tolerated in this study, with a safety profile similar to the placebo.
These results demonstrate that montelukast decreases airway eosinophilic inflammation in addition to improving clinical parameters. Its efficacy in the treatment of chronic asthma may be due, in part, to the effect on airway inflammation.</description><subject>Acetates - therapeutic use</subject><subject>Adult</subject><subject>Airway inflammation</subject><subject>asthma</subject><subject>Asthma - complications</subject><subject>Asthma - drug therapy</subject><subject>Asthma - physiopathology</subject><subject>Biological and medical sciences</subject><subject>cysteinyl leukotriene receptor antagonists</subject><subject>Double-Blind Method</subject><subject>Eosinophils - drug effects</subject><subject>Female</subject><subject>Humans</subject><subject>Leukocyte Count - drug effects</subject><subject>Leukotriene Antagonists - therapeutic use</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>montelukast</subject><subject>Pharmacology. Drug treatments</subject><subject>Pulmonary Eosinophilia - complications</subject><subject>Pulmonary Eosinophilia - drug therapy</subject><subject>Pulmonary Eosinophilia - physiopathology</subject><subject>Quinolines - therapeutic use</subject><subject>Respiratory Function Tests</subject><subject>Respiratory system</subject><subject>Respiratory Tract Diseases - complications</subject><subject>Respiratory Tract Diseases - drug therapy</subject><subject>Respiratory Tract Diseases - pathology</subject><subject>Safety</subject><subject>Sputum - cytology</subject><subject>Sputum - drug effects</subject><subject>sputum eosinophils</subject><subject>Treatment Outcome</subject><issn>0903-1936</issn><issn>1399-3003</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkM1uEzEURi0EoqHwCsgLxIoZrn9mMmaBVFWlBRUhIdhi3Xhs4uAZB3tGaXh6HBJRlqyuLJ_7ffYhhDKoGQj5elMzoVQlAETNlFI1kwiyvntAFn8vHpIFKBAVU6I9I09y3gCwVgr2mJwxkJ3qOF-Qbx_jONkw_8A80WT72dhM0acd7qmN2Y9xu_bBG-pHF3AYcPJxLAda-PWAbyjShGMfB__L9q-oKWkphmB7OiWP4Sl55DBk--w0z8nXd1dfLm-q20_X7y8vbivTSJAVGt4B8PKTznCjJJesV41ZrTrRN0thJFsuReMcgup659oyWmgYb9GuGnQgzsnLY-42xZ-zzZMefDY2BBxtnLNeApTQlhewO4ImxZyTdXqb_IBprxnog1u90QeF-qBQH9zqP271XVl9fuqYV4Pt_1k8yizAixOA2WBwRYzx-Z5TvJOiKdjbI7bzwe7_u19fff7A5AXI-561_77e-WR1HjCE8iymbdowqZlmXPwG6lCisg</recordid><startdate>199907</startdate><enddate>199907</enddate><creator>Pizzichini, E</creator><creator>Leff, JA</creator><creator>Reiss, TF</creator><creator>Hendeles, L</creator><creator>Boulet, LP</creator><creator>Wei, LX</creator><creator>Efthimiadis, AE</creator><creator>Zhang, J</creator><creator>Hargreave, FE</creator><general>Eur Respiratory Soc</general><general>European Respiratory Journal</general><general>Maney</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>199907</creationdate><title>Montelukast reduces airway eosinophilic inflammation in asthma: a randomized, controlled trial</title><author>Pizzichini, E ; Leff, JA ; Reiss, TF ; Hendeles, L ; Boulet, LP ; Wei, LX ; Efthimiadis, AE ; Zhang, J ; Hargreave, FE</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5404-ac280029998c2c94241d95cbb83d573c417735ffa098dff6098605126aeb5af03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Acetates - therapeutic use</topic><topic>Adult</topic><topic>Airway inflammation</topic><topic>asthma</topic><topic>Asthma - complications</topic><topic>Asthma - drug therapy</topic><topic>Asthma - physiopathology</topic><topic>Biological and medical sciences</topic><topic>cysteinyl leukotriene receptor antagonists</topic><topic>Double-Blind Method</topic><topic>Eosinophils - drug effects</topic><topic>Female</topic><topic>Humans</topic><topic>Leukocyte Count - drug effects</topic><topic>Leukotriene Antagonists - therapeutic use</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>montelukast</topic><topic>Pharmacology. Drug treatments</topic><topic>Pulmonary Eosinophilia - complications</topic><topic>Pulmonary Eosinophilia - drug therapy</topic><topic>Pulmonary Eosinophilia - physiopathology</topic><topic>Quinolines - therapeutic use</topic><topic>Respiratory Function Tests</topic><topic>Respiratory system</topic><topic>Respiratory Tract Diseases - complications</topic><topic>Respiratory Tract Diseases - drug therapy</topic><topic>Respiratory Tract Diseases - pathology</topic><topic>Safety</topic><topic>Sputum - cytology</topic><topic>Sputum - drug effects</topic><topic>sputum eosinophils</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pizzichini, E</creatorcontrib><creatorcontrib>Leff, JA</creatorcontrib><creatorcontrib>Reiss, TF</creatorcontrib><creatorcontrib>Hendeles, L</creatorcontrib><creatorcontrib>Boulet, LP</creatorcontrib><creatorcontrib>Wei, LX</creatorcontrib><creatorcontrib>Efthimiadis, AE</creatorcontrib><creatorcontrib>Zhang, J</creatorcontrib><creatorcontrib>Hargreave, FE</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The European respiratory journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pizzichini, E</au><au>Leff, JA</au><au>Reiss, TF</au><au>Hendeles, L</au><au>Boulet, LP</au><au>Wei, LX</au><au>Efthimiadis, AE</au><au>Zhang, J</au><au>Hargreave, FE</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Montelukast reduces airway eosinophilic inflammation in asthma: a randomized, controlled trial</atitle><jtitle>The European respiratory journal</jtitle><addtitle>Eur Respir J</addtitle><date>1999-07</date><risdate>1999</risdate><volume>14</volume><issue>1</issue><spage>12</spage><epage>18</epage><pages>12-18</pages><issn>0903-1936</issn><eissn>1399-3003</eissn><abstract>Leukotrienes are pro‐inflammatory mediators which may contribute to tissue, sputum, and blood eosinophilia seen in allergic and inflammatory diseases, including asthma. Montelukast is a cysteinyl leukotriene1 (CysLT1) receptor antagonist which improves asthma control; the aim of this study was to investigate its effect on induced sputum eosinophils.
Montelukast 10 mg (n=19) or placebo (n=21) were administered orally once in the evening for 4 weeks to 40 chronic adult asthmatic patients, aged 19–64 yrs, in a double‐blind, randomized, parallel group study. Patients were included if, at prestudy, they had >5% sputum eosinophils, symptomatic asthma with a forced expiratory volume in one second ≥65% of the predicted value and were being treated only with “as needed” inhaled β2‐agonists. In addition to sputum eosinophils, blood eosinophils and clinical endpoints were also assessed.
Four weeks of montelukast treatment decreased sputum eosinophils from 7.5% to 3.9% (3.6% decrease, 95% confidence interval (CI) ‐16.6–0.4). In contrast, placebo treatment was associated with an increase in sputum eosinophils from 14.5% to 17.9% (3.4% increase, 95% CI ‐3.5–9.8). The least squares mean difference between groups (‐11.3%, 95% CI ‐21.1–‐1.4) was significant (p=0.026). Compared with placebo, montelukast significantly reduced blood eosinophils (p=0.009), asthma symptoms (p=0.001) and β2‐agonist use (p<0.001) while significantly increasing morning peak expiratory flow (p=0.001). Montelukast was generally well tolerated in this study, with a safety profile similar to the placebo.
These results demonstrate that montelukast decreases airway eosinophilic inflammation in addition to improving clinical parameters. Its efficacy in the treatment of chronic asthma may be due, in part, to the effect on airway inflammation.</abstract><cop>Oxford, UK</cop><pub>Eur Respiratory Soc</pub><pmid>10489822</pmid><doi>10.1034/j.1399-3003.1999.14a04.x</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Acetates - therapeutic use Adult Airway inflammation asthma Asthma - complications Asthma - drug therapy Asthma - physiopathology Biological and medical sciences cysteinyl leukotriene receptor antagonists Double-Blind Method Eosinophils - drug effects Female Humans Leukocyte Count - drug effects Leukotriene Antagonists - therapeutic use Male Medical sciences Middle Aged montelukast Pharmacology. Drug treatments Pulmonary Eosinophilia - complications Pulmonary Eosinophilia - drug therapy Pulmonary Eosinophilia - physiopathology Quinolines - therapeutic use Respiratory Function Tests Respiratory system Respiratory Tract Diseases - complications Respiratory Tract Diseases - drug therapy Respiratory Tract Diseases - pathology Safety Sputum - cytology Sputum - drug effects sputum eosinophils Treatment Outcome |
| title | Montelukast reduces airway eosinophilic inflammation in asthma: a randomized, controlled trial |
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