Effects of montelukast on surrogate inflammatory markers in corticosteroid-treated patients with asthma
Effects of montelukast on surrogate inflammatory markers in corticosteroid-treated patients with asthma
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DOI：
10.1164/rccm.200209-1116oc
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发表时间：
2003-05-01
影响因子：
24.7
通讯作者：
Lipworth, BJ
中科院分区：
文献类型：
--
作者：
Currie, GP;Lee, DKC;Lipworth, BJ
我们评估了孟鲁司特是否在接受氟替卡松/沙美特罗（FP/SM）联合治疗和单独使用FP治疗的哮喘患者中产生累加效应。22例轻度至中度哮喘患者完成了一项双盲、安慰剂对照研究。在使用FP 250 mug/SM 50 mug 1 puff每日两次进行2周的导入后，患者进入随机交叉期，接受额外的孟鲁司特10 mg每日或安慰剂各3周。在前2周，他们接受FP/SM 1喷BID，然后在第3周接受FP 250 μ g 1喷BID。主要结果是腺苷酸激发阈值和恢复时间;次要结果包括替代炎症标志物和肺功能。与FP/SM导入期相比，在FP/SM中添加孟鲁司特对于炎性标志物而不是肺功能优于安慰剂（p < 0.05）。对于腺苷酸阈值、恢复、呼出的一氧化氮和血嗜酸性粒细胞，几何平均倍数分别为1.4（95%置信区间，1.1-1.8），10分钟（3-17分钟），2.1 ppm（0.2-3.9 ppm）和88（34-172）x 10（6）/L。FP+孟鲁司特联合治疗的炎症标志物上级优于FP/SM，但肺功能较差。因此，在服用FP/SM或FP的患者中，孟鲁司特对与肺功能无关的替代炎症标志物具有互补作用。需要进一步的研究来评估孟鲁司特的这些作用是否转化为临床益处。
We evaluated whether montelukast conferred additive effects in patients with asthma receiving fluticasone/salmeterol (FP/SM) combination and FP alone. Twenty-two patients with mild to moderate asthma completed a double-blind, placebo-controlled study. After a 2-week run-in using FP 250 mug/SM 50 mug 1 puff twice daily, patients entered a randomized crossover period to receive additional montelukast 10 mg daily or placebo for 3 weeks each. For the first 2 weeks, they received FP/SM 1 puff BID, and then they received FP 250 mug 1 puff BID for the 3rd week. The primary outcome was adenosine monophosphate challenge threshold and recovery time; secondary outcomes included surrogate inflammatory markers and lung function. Compared with FP/SM run-in, adding montelukast to FP/SM was better (p < 0.05) than placebo for inflammatory markers but not for lung function. For adenosine monophosphate threshold, recovery, exhaled nitric oxide, and blood eosinophils, there were 1.4 (95% confidence interval, 1.1-1.8) geometric mean fold, 10 minutes (3-17 minutes), 2.1 parts per billion (0.2-3.9 parts per billion), and 88 (34-172) x 10(6)/L differences, respectively. The combination of FP plus montelukast was superior to FP/SM for inflammatory markers but was inferior for lung function. Thus, in patients taking FP/SM or FP, montelukast conferred complimentary effects on surrogate inflammatory markers, which were dissociated from lung function. Further studies are required to evaluate whether these effects of montelukast translate into clinical benefits.