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Comparison of add-on therapy to inhaled fluticasone propionate in children with asthma: Residual volume and exhaled nitric oxide as outcome measures

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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

DOI: https://doi.org/10.2500/aap.2007.28.3054

Affiliations: 1: Servizio di Allergologia e Fisiopatologia Respiratoria Infantile, Clinica Pediatrica Universita' di Chieti, Italy 2: Clinica Pediatrica Universita' di Verona, Verona, Italy

Publication date: 2007-11-01

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  • Allergy and Asthma Proceedings is a peer reviewed publication dedicated to distributing timely scientific research regarding advancements in the knowledge and practice of allergy, asthma and immunology. Its primary readership consists of allergists and pulmonologists.

    The goal of the Proceedings is to publish articles with a predominantly clinical focus which directly impact quality of care for patients with allergic disease and asthma.

    Featured topics include asthma, rhinitis, sinusitis, food allergies, allergic skin diseases, diagnostic techniques, allergens, and treatment modalities. Published material includes peer-reviewed original research, clinical trials and review articles.

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    The journal is indexed in Thomson Reuters Web of Science and Science Citation Index Expanded, plus the National Library of Medicine's PubMed service.
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