J. Tamaoki et al., LEUKOTRIENE ANTAGONIST PREVENTS EXACERBATION OF ASTHMA DURING REDUCTION OF HIGH-DOSE INHALED CORTICOSTEROID, American journal of respiratory and critical care medicine, 155(4), 1997, pp. 1235-1240
Citations number
29
Categorie Soggetti
Emergency Medicine & Critical Care","Respiratory System
To test whether the leukotriene antagonist ONO-1078 (pranlukast) preve
nts asthma exacerbations during reduction of high-dose inhaled cortico
steroid, we conducted a randomized, double-blind, placebo-controlled s
tudy in 79 asthma patients requiring high doses (1,500 mu g/d or more)
of inhaled beclomethasone dipropionate (BDI) for clinical control (du
ration of asthma, 11.0 +/- 3.1 yr; duration of BDI treatment, 0.5 +/-
0.3 yr; FEV(1) percentage of predicted, 80.7 +/- 2.0%). After a 2-wk r
un-in period, the doses of BDI were halved, while the patients were as
signed to receive orally ONO-1078, 450 mg twice daily, or placebo. In
the placebo group FEV(1) decreased by 0.33 +/- 0.20 L after 6 wk (p <
0.001). Likewise, morning and evening PEF decreased by 46 +/- 7 L/min
and 18 +/- 6 L/min, respectively. By contrast these variables were sus
tained above baseline in the ONO-1078 group. The number of daytime and
nighttime asthma symptoms and the use of beta(2)-agonist increased in
the placebo group, whereas they remained unchanged in the ONO-1078 gr
oup. In the placebo group concentrations of serum eosinophil cationic
protein and exhaled nitric oxide increased (p = 0.007 and p = 0.025, r
espectively), compared with no change in the ONO-1078 group. Therefore
, the leukotriene antagonist ONO-1078 prevents the asthma deterioratio
n provoked by a 6-wk reduction of the dose of inhaled BDI into half.