Montelukast as add-on therapy to inhaled corticosteroids in the management of asthma (the SAS trial)
- PMID: 19557206
- PMCID: PMC3486710
- DOI: 10.1155/2009/593753
Montelukast as add-on therapy to inhaled corticosteroids in the management of asthma (the SAS trial)
Abstract
Aim: To evaluate the effectiveness of montelukast as add-on therapy for asthmatic patients who remain uncontrolled with low, moderate or high doses of inhaled corticosteroid monotherapy.
Design: An eight-week, multicentre, open-label, observational study.
Results: Of 320 patients enrolled, 288 (90.0%) completed the study. Of patients who had uncontrolled asthma symptoms (Canadian Asthma Consensus Guidelines Update, 2003) but were controlled according to the Asthma Control Questionnaire (ACQ score of less than 1.5), 93.9% maintained asthma control at week 8. Of patients with uncontrolled asthma at baseline for both definitions, 63.5% achieved asthma control by week 8. The mean +/- SD ACQ score decreased from 1.13+/-0.28 to 0.57+/-0.50 (P<0.001) for controlled patients at baseline and from 2.38+/-0.73 to 1.03+/-0.80 (P<0.001) for patients who were uncontrolled at baseline, each representing a clinically significant improvement.
Conclusion: Montelukast add-on therapy is an effective alternative to inhaled corticosteroid monotherapy.
OBJECTIF :: Évaluer l’efficacité du montélukast comme traitement d’appoint chez les patients asthmatiques dont la maladie ne peut être maîtrisée au moyen d’une monothérapie par un corticostéroïde en inhalation administré à faible dose, à dose modérée ou à dose élevée.
PROTOCOLE D’ÉTUDE :: Étude d’observation multicentrique de 8 semaines menée au su.
RÉSULTATS :: Sur les 320 patients ayant pris part à l’étude, 288 (90,0 %) l’ont terminée. Parmi les patients dont les symptômes de l’asthme n’étaient pas maîtrisés (d’après la mise à jour des lignes directrices de la Conférence canadienne de consensus sur l’asthme, 2003), mais qui l’étaient selon le Questionnaire sur la maîtrise de l’asthme (indice QMA inférieur à 1,5), 93,9 % présentaient une maîtrise de l’asthme à la 8e semaine. Sur l’ensemble des patients dont l’asthme n’était pas maîtrisé au début de l’étude d’après les 2 définitions, 63,5 % ont présenté une maîtrise de la maladie à la 8e semaine. L’indice QMA moyen ± écart type (É.T.) est passé de 1,13 ± 0,28 à 0,57 ± 0,50 (p < 0,001) chez les patients dont l’asthme était maîtrisé au départ et de 2,38 ± 0,73 à 1,03 ± 0,80 (p < 0,001) chez les patients dont l’asthme n’était pas maîtrisé au départ; ces améliorations étaient toutes deux significatives sur le plan statistique.
CONCLUSION :: Le traitement d’appoint par le montélukast est une option de rechange efficace à la monothérapie par un corticostéroïde en inhalation.
Trial registration: ClinicalTrials.gov NCT00755794.
Figures
Similar articles
-
Montelukast as add-on therapy with inhaled corticosteroids alone or inhaled corticosteroids and long-acting beta-2-agonists in the management of patients diagnosed with asthma and concurrent allergic rhinitis (the RADAR trial).Can Respir J. 2009 May-Jun;16 Suppl A(Suppl A):17A-31A. doi: 10.1155/2009/145071. Can Respir J. 2009. PMID: 19557208 Free PMC article. Clinical Trial.
-
Montelukast as an alternative to low-dose inhaled corticosteroids in the management of mild asthma (the SIMPLE trial): an open-label effectiveness trial.Can Respir J. 2009 May-Jun;16 Suppl A(Suppl A):11A-21A. doi: 10.1155/2009/429482. Can Respir J. 2009. PMID: 19557207 Free PMC article. Clinical Trial.
-
Efficacy of add-on montelukast in patients with non-controlled asthma: a Belgian open-label study.Curr Med Res Opin. 2009 Feb;25(2):489-97. doi: 10.1185/03007990802667937. Curr Med Res Opin. 2009. PMID: 19192994 Clinical Trial.
-
Montelukast: data from clinical trials in the management of asthma.Ann Pharmacother. 1999 Dec;33(12):1299-314. doi: 10.1345/aph.18430. Ann Pharmacother. 1999. PMID: 10630831 Review.
-
Clinical effectiveness of inhaled corticosteroids versus montelukast in children with asthma: prescription patterns and patient adherence as key factors.Curr Med Res Opin. 2012 Jan;28(1):111-9. doi: 10.1185/03007995.2011.640668. Epub 2011 Dec 16. Curr Med Res Opin. 2012. PMID: 22077107 Review.
Cited by
-
Real-life asthma care in Canada.Can Respir J. 2009 May-Jun;16 Suppl A(Suppl A):3A-6A. doi: 10.1155/2009/328963. Can Respir J. 2009. PMID: 19557205 Free PMC article. Review. No abstract available.
-
Anti-leukotriene agents compared to inhaled corticosteroids in the management of recurrent and/or chronic asthma in adults and children.Cochrane Database Syst Rev. 2012 May 16;2012(5):CD002314. doi: 10.1002/14651858.CD002314.pub3. Cochrane Database Syst Rev. 2012. PMID: 22592685 Free PMC article.
-
Addition of Montelukast to Low-Dose Inhaled Corticosteroid Leads to Fewer Exacerbations in Older Patients Than Medium-Dose Inhaled Corticosteroid Monotherapy.Allergy Asthma Immunol Res. 2015 Sep;7(5):440-8. doi: 10.4168/aair.2015.7.5.440. Epub 2015 Apr 7. Allergy Asthma Immunol Res. 2015. PMID: 26122504 Free PMC article.
-
More Effective Strategies are Needed for Elderly Asthmatics in Real-World Practice.Allergy Asthma Immunol Res. 2015 Sep;7(5):419-20. doi: 10.4168/aair.2015.7.5.419. Allergy Asthma Immunol Res. 2015. PMID: 26122501 Free PMC article. No abstract available.
-
Effect of montelukast on the expression of CD4+CD25+ regulatory T cells in children with acute bronchial asthma.Exp Ther Med. 2018 Sep;16(3):2381-2386. doi: 10.3892/etm.2018.6485. Epub 2018 Jul 19. Exp Ther Med. 2018. PMID: 30210590 Free PMC article.
References
-
- Lemiere C, Bai T, Balter M, et al. Adult Asthma Consensus Guidelines Update 2003. Can Respir J. 2004;11(Suppl A):9A–18A. - PubMed
-
- Bateman ED, Hurd SS, Barnes PJ, et al. Global strategy for asthma management and prevention: GINA executive summary. Eur Respir J. 2008;31:143–78. - PubMed
-
- Pauwels RA, Pedersen S, Busse WW, et al. Early intervention with budesonide in mild persistent asthma: A randomised, double-blind trial. Lancet. 2003;361:1071–6. - PubMed
-
- Global Strategy for Asthma Management and Prevention. Global Initiative for Asthma (GINA), 2006. <www.ginasthma.org> (Version current 2006).
-
- National Asthma Education and Prevention Program: Expert Panel Report: Guidelines for the diagnosis and management of asthma. Update on selected topics – 2002. J Allergy Clin Immunol. 2002;110(Suppl 1):S141–S219. - PubMed