Comparison of montelukast and budesonide on bronchial reactivity in subjects with mild-moderate persistent asthma

We studied 51 atopic non-smoking subjects who were divided to four treatments groups: (A) montelukast 10 mg daily, (B) budesonide 400 mug twice a day (bid), (C) montelukast 10 mg daily plus budesonide 400 mug bid and (D) budesonide 800 mug bid. Bronchial responsiveness was assessed before and after 12 weeks of treatment. The bronchial responsiveness, evaluated by means Of PC20 values, showed a strong significant increase in groups B, C and D, and a weak but significant rise in group A, when compared to basal data. Regarding other pulmonary parameters (FEV1, PEF) there were no significant differences among the groups after 12 weeks of therapy. A statistical significance was founded after therapy between group A and C (p < 0.05), but not between the group B and D treated with only budesonide at different doses. No significant differences was observed in the side effect pattern among the various treatments. The study data demonstrated that administration of montelukast provided an important and additional effect on bronchial hyperresponsiveness. Oral administration represents a significant advantage over the majority of other anti-asthmatic drugs. Our results confirm the anti-inflammatory properties of both the inhaled corticosteroid (ICS) and montelukast and the possible role of these drugs can have on airway remodelling. While currently low dose ICS remains the reference drug as a controller in mild-moderate persistent asthma, montelukast may be viewed as a possible option, either in monotherapy or in association. (C) 2003 Elsevier Science Ltd. All rights reserved.