POSSIBILITIES FOR THE USE OF THE ANTI-LEUKOTRIENE DRUG MONTELUKAST IN COMBINED THERAPY OF PATIENTS WITH BRONCHIAL ASTHMA AND COLD-INDUCED BRONCHIAL HYPERACTIVITY

• Published in: Klinicheskaia meditsina Vol. 93; no. 9; p. 30
• Main Authors: Kolosov, V P, Pirogov, A B, Perel'Man, Yu M, Prikhod'ko, A G, Mal'tseva, T A, Semenova, G V, Borodin, E A, Kolosov, A V
• Format: Journal Article
• Language: Russian
• Published: Russia (Federation) 2015
• Subjects: Acetates - administration & dosage; Administration, Inhalation; Adolescent; Adult; Anti-Asthmatic Agents - administration & dosage; Asthma - complications; Asthma - drug therapy; Bronchial Hyperreactivity - complications; Bronchial Hyperreactivity - drug therapy; Cold Temperature - adverse effects; Female; Follow-Up Studies; Humans; Male; Middle Aged; Prospective Studies; Quinolines - administration & dosage; Treatment Outcome; Young Adult
• ISSN: 0023-2149

To study effectiveness of the use of the anti-leukotriene drug montelukast in combination with inhalation glucocorticoid and long-acting beta-agonist in patients with bronchial asthma (BA) and cold-induced bronchial hyperactivity (CBHA) with a view to optimizing control of the disease.
We carried out an open comparative prospective study of patients with persistent BA in a cold season under conditions of real clinical practice. The patients were divided into 2 groups. Group 1 included patients with CBHA, group 2 consisted of subjects with constant bronchial reactivity in response to cold in the standard provocative test. The patients were followed up for 24 weeks. During the first 12 weeks of the treatment, the patients of group I were given sodium montelukast with budesonide/formoterol. In the next 12 weeks they received only budesonide/formoterol at the same dose. Patients of group 2 were treated with budesonide/formoterol during the entire study period. Efficacy of therapy was assessed by asthma control test (ACT).
Control of BA in group 1 (20-25 scores in A CT) was achieved in 83% of the patients within the first 12 week period The result was comparable (87%) with that in group 2. Impairment of control (to 52%) was documented in group I during the last 12 weeks although it was preserved (20-25 scores) in group 2 (81%).
The use of sodium montelukast in combination with budesonide/formoterol for the treatment of BA with CBHA in winter season ensured control of the disease in most patients during 12 weeks. Withdrawal of montelukast in the subsequent period leads to the loss of control and a rise in the frequency of exacerbation.