Effect of montelukast added to inhaled budesonide on control of mild to moderate asthma

Vaquerizo, M J; Casán, Pere; Castillo, José A. García del; Perpiñá, M.; Sanchís, J.; Sobradillo, V.; Valência, Alberto; Verea, Héctor; Viejo, José Luís; Villasante, C.; González‐Esteban, Jorge; Picado, César

doi:10.1136/thorax.58.3.204

Cited by 144 publications

(126 citation statements)

References 36 publications

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“…However, when used alone as controller, the effects of leukotriene modifiers are less than those of low doses of inhaled glucocorticosteroids and, in patients already on inhaled glucocorticosteroids, leukotriene modifiers cannot substitute for this treatment without risking the loss of asthma control [80,81]. Leukotriene modifiers used as add-on therapy may reduce the dose of inhaled glucocorticosteroids required by patients with moderate to severe asthma [82], and may improve asthma control in patients whose asthma is not controlled with low or high doses of inhaled glucocorticosteroids [81,[83][84][85]. With the exception of one study that has demonstrated equivalence in preventing exacerbations [86], several studies have demonstrated that leukotriene modifiers are less effective than long-acting inhaled b 2 -agonists as addon therapy [87][88][89][90].…”

Section: Leukotriene Modifiersmentioning

confidence: 99%

“…Leukotriene modifiers as add-on treatment to medium-highdose inhaled glucocorticosteroids provides benefit in some patients (Evidence A), but usually less than that achieved with the addition of a long-acting b 2 -agonist (Evidence A) [81][82][83][84][85]303]. The addition of a low dose of sustained-release theophylline [116] to medium-or high-dose inhaled glucocorticosteroid and long-acting b 2 -agonist may also provide benefit (Evidence B) [115].…”

Section: Treatment Steps For Achieving Controlmentioning

confidence: 99%

See 1 more Smart Citation

Global strategy for asthma management and prevention: GINA executive summary

Bateman

Ss²,

Barnes³

et al. 2008

European Respiratory Journal

2,643

2,301

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Asthma is a serious health problem throughout the world. During the past two decades, many scientific advances have improved our understanding of asthma and ability to manage and control it effectively. However, recommendations for asthma care need to be adapted to local conditions, resources and services. Since it was formed in 1993, the Global Initiative for Asthma, a network of individuals, organisations and public health officials, has played a leading role in disseminating information about the care of patients with asthma based on a process of continuous review of published scientific investigations. A comprehensive workshop report entitled ''A Global Strategy for Asthma Management and Prevention'', first published in 1995, has been widely adopted, translated and reproduced, and forms the basis for many national guidelines. The 2006 report contains important new themes. First, it asserts that ''it is reasonable to expect that in most patients with asthma, control of the disease can and should be achieved and maintained,'' and recommends a change in approach to asthma management, with asthma control, rather than asthma severity, being the focus of treatment decisions. The importance of the patient-care giver partnership and guided self-management, along with setting goals for treatment, are also emphasised.

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Section: Leukotriene Modifiersmentioning

confidence: 99%

Section: Treatment Steps For Achieving Controlmentioning

confidence: 99%

Global strategy for asthma management and prevention: GINA executive summary

Bateman

Ss²,

Barnes³

et al. 2008

European Respiratory Journal

2,643

2,301

View full text Add to dashboard Cite

show abstract

“…When added to ICS, montelukast induced further improvement in symptoms and pulmonary function, particularly in patients still symptomatic despite treatment with ICS [Vaquerizo et al 2003;Laviolette et al 1999].…”

Section: Montelukast As Add-on Therapymentioning

confidence: 99%

Montelukast in asthma: a review of its efficacy and place in therapy

Paggiaro

Bacci

2010

Therapeutic Advances in Chronic Disease

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Many studies have been published in the last 10 years on the efficacy and safety of montelukast in asthma since this drug entered the market. Experimental studies, in vitro and in vivo, and clinical studies on large numbers of patients with asthma of different severity have clearly demonstrated that montelukast is able to modify the pathophysiological mechanisms of the disease, and to improve to some extent the clinical and functional manifestations of asthma. Studies of montelukast as monotherapy or in combination with other drugs, mainly inhaled corticosteroids (ICS), versus different comparator drugs have contributed to the positioning of montelukast in the different levels of asthma treatment, according to the Global Initiative for Asthma Guidelines. Montelukast may be used as monotherapy as an alternative to low-dose ICS (particularly in a step-down strategy) or in addition to ICS for improving clinical manifestations by an increase in anti-inflammatory effects and a sparing of corticosteroids. The heterogeneity of asthma has received a large amount of attention in the last few years in order to better tailor treatment according to the different clinical and biological phenotypes of asthma. Montelukast has proven to be particularly effective in exercise-induced asthma and in asthma associated with allergic rhinitis. Other phenotypes where montelukast is effective include asthma in obese patients, asthma in smokers, aspirin-induced asthma and viralinduced wheezing episodes. The safety profile of montelukast is very good, and the suspicions of increased risk of ChurgStrauss syndrome or suicide have not been confirmed.

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“…17,18 Leukotriene receptor antagonists reduce the dose of ICS required by patients with moderate to severe asthma and improve asthma control in patients who are not well controlled with ICS monotherapy. 19,20 Hozawa et al investigated the add-on effects of a tulobuterol patch on peak morning expiratory flow, bronchial hyperresponsiveness, and eosinophilic airways inflammation. 21 Twenty-four patients with asthma already receiving ICS alone were randomized to receive either ICS ± a 2 mg/day tulobuterol patch for four weeks.…”

Section: Clinical Efficacymentioning

confidence: 99%

Long-term safety, efficacy, and patient acceptability of the tulobuterol patch

Ichikawa¹,

Sugiura²

2013

RRTD

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Abstract:The tulobuterol patch contains a β 2 -adrenergic agonist, is the first transdermal bronchodilator, and was developed in Japan. It relies on a matrix-type transdermal delivery system that contains both crystallized and molecular forms of tulobuterol. This delivery system enables the drug content to be released steadily over 24 hours. When the tulobuterol patch is applied to the skin at bedtime, the serum concentration of tulobuterol peaks in the early morning, suppressing the morning dip in pulmonary function. This pharmacological property also prevents steep increases in plasma drug levels, which reduces the risk of adverse events. Because the tulobuterol patch is easy to use and requires only once-daily application, treatment adherence in patients using the patch is superior to that of other therapies. The clinical efficacy of the patch in patients with asthma and chronic obstructive pulmonary disease at any age has been established in many clinical studies since launch in 1998, and the product has a good safety profile. Therefore, the tulobuterol patch is currently used for the long-term treatment of patients with asthma and chronic obstructive pulmonary disease. Here we review the characteristics of the tulobuterol patch and the results of clinical trials that have investigated the effects of the patch on pulmonary function, quality of life, and adherence. We also discuss the usefulness of the tulobuterol patch in clinical practice.

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Effect of montelukast added to inhaled budesonide on control of mild to moderate asthma

Cited by 144 publications

References 36 publications

Global strategy for asthma management and prevention: GINA executive summary

Global strategy for asthma management and prevention: GINA executive summary

Montelukast in asthma: a review of its efficacy and place in therapy

Long-term safety, efficacy, and patient acceptability of the tulobuterol patch

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