Drug Combination Doesn't Improve Asthma Control

Low-dose budesonide plus montelukast inferior to higher-dose budesonide in treating children

THURSDAY, Sept. 28 (HealthDay News) -- In children with moderate persistent asthma, treatment with montelukast and a lower dose of inhaled budesonide results in poorer asthma control than treatment with a higher dose of inhaled budesonide alone, according to the results of a study published in the September issue of Annals of Allergy, Asthma & Immunology.

Gokul Chand Jat, M.D., of the Post Graduate Institute of Medical Education and Research in Chandigarh, India, and colleagues randomly assigned 71 children to either 200 μg of daily inhaled budesonide plus a 5-mg chewable tablet of montelukast, or 400 μg of inhaled budesonide daily alone.

The researchers found no significant group differences in forced expiratory volume in one second, peak expiratory flow rate and Asthma Symptom Scores. But they found that the group treated with 400 μg of budesonide had fewer asthma exacerbations than those treated with the lower dose of budesonide plus montelukast (9.1 percent versus 33.3 percent).

"The findings do not altogether negate a possible role for montelukast or other leukotriene antagonists in the management of persistent childhood asthma," the authors write. "It is possible that the addition of montelukast to the standard dose of inhaled corticosteroid therapy may improve overall asthma control by decreasing the frequency of exacerbations or shortening the duration of inhaled corticosteroids, thereby increasing the acceptability of inhalation therapy among children."

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