Comparison of add-on therapy to inhaled fluticasone propionate in children with asthma: Residual volume and exhaled nitric oxide as outcome measures
Abstract:The purpose of this study was to evaluate changes in lung function and fractional exhaled nitric oxide (FeNO) in children with mild to moderate persistent asthma treated with low-dose inhaled steroids but still manifesting significantly increased residual volume (RV). This was a crossover study evaluating lung function and FeNO before and after a 2-week crossover therapy period by adding either montelukast or salmeterol to inhaled fluticasone propionate in 12 children with asthma. Salmeterol increased forced expiratory volume at 1 second (FEV1) and decreased RV without effects on eNO. Addition of montelukast produced a statistically significant decrease both for RV (from 191.7 ± 60.8% to 132.4 ± 36.1%; p = 0.03) and for eNO (from 14.0 ± 6.3 ppb to 8. 5± 5.0 ppb; p < 0.01). No effect was observed for the montelukast treatment period in FEV1 and forced expiratory flow at 25–75%. Add-on therapy may reduce RV and decrease levels of FeNO, leading to consideration of a possible anti-inflammatory additive effect that could improve the control of the disease.
Keywords: Anti-inflammatory; asthma control; combination therapy; exhaled nitric oxide; inhaled corticosteroid; leukotriene receptor antagonist; long-acting beta-agonist; montelukast; pediatric; salmeterol
Document Type: Research Article
Publication date: 2007-11-01
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