Archive \ Volume.5 2014 Issue 2

Comparison of efficacy between long‑acting beta 2‑agonists (formoterol fumarate) and leukotriene‑receptor antagonists (montelukast) as add‑on therapy to inhaled corticosteroids (budesonide) in moderate persistent asthma

Sasikala Kumaravel , Kingston Rajiah , Suchandra Sen
Abstract

Objective: This study was aimed to compare the efficacy between long‑acting beta 2‑agonists and leukotr i ene receptor antagonists as add‑on therapy to inhaled corticosteroids in moderate persistent asthma. Materials and Methods: This study was carried out at the Kovai Medical Center and Hospital, in Coimbatore. The study protocol was approved by the Ethics committee of the Kovai Medical Center and Hospital. Patients with asthma in the outpatient respiratory department were included in the study. Out of 100 patients, 46 patients received the combination product, budesonide 400 μg and formoteral fumarate 6μg as an inhaled dose and this group was named group A. The other group had 44 patients and was prescribed oral montelukast 10 mg along with budesonide 400 μg as an inhaled dose. This group was called group B. The parameters recorded included, pulmonary function test reports, MBDS (Modified Borg’s Dyspnea Scale). The quality of life was evaluated both before and after the treatment period by the SGRQ (St. George’s Respiratory Questionnaire). Results: The two groups, group A and group B were assessed for pulmonary activity. The initial results of the score (MBDS) were 3.3 ± 0.12 and 3.2 ± 0.13 for group A and group B, respectively. Scores were reduced to 0.19 ± 0.08 and 0.35 ± 0.08 respectively after one month of therapy. For group A, the mean values for forced expiratory volume in one second (FEV1), peak expiratory flow (PEF) and forced vital capacity (FVC) before treatment were 1.4 ± 0.1, 3.2 ± 0.33 and 1.8 ± 0.18, respectively, whereas after treatment the values were 2 ± 0.14, 5.2 ± 0.41 and 2.4 ± 0.17. For group B the mean FEV1, PEV and FVC, before and after therapy were 1.2 ± 0.1 - 1.8 ± 0.17; 3.1 ± 0.3 - 5.4 ± 0.42; 1.8 ± 0.17 - 2.4 ± 0.22 respectively. Conclusions: In our conclusion, we suggest that a montelukast is as effective as formoterol fumarate for add‑on therapy to budesonide in moderate persistent asthma. Hence, montelukast can be considered an alternate therapeutic option for such patients. The results of this study are expected to provide physicians with clinical evidence to help them make a rational decision when treating patients with moderate persistent asthma.