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Efficacy of add-on montelukast in nonasthmatic eosinophilic bronchitis: the additive effect on airway inflammation, cough and life quality.

Bao W, Liu P, Qiu Z, Yu L, Hang J, Gao X, Zhou X - Chin. Med. J. (2015)

Bottom Line: After 2-week treatment, add-on treatment of MONT was significantly more effective than BUD monotherapy for CVAS decrease and LCQ scores improvement (both P < 0.05).Similar results were seen at 4-week assessment (both P < 0.05). 4-week add-on therapy of MONT also resulted in a higher percentage of patients with normal sputum Eos (<2.5%) and greater decrease of ECP (both P < 0.05).MONT combined with BUD was demonstrated cooperative effects in improvement of life quality, suppression of eosinophilic inflammation, and cough remission in patients with NAEB.

View Article: PubMed Central - PubMed

Affiliation: Department of Respiratory Medicine, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai 200080, China.

ABSTRACT

Background: The efficacy of montelukast (MONT), a cysteinyl leukotriene receptor antagonist, in nonasthmatic eosinophilic bronchitis (NAEB), especially its influence on cough associated life quality is still indefinite. We evaluated the efficacy of MONT combined with budesonide (BUD) as compared to BUD monotherapy in improving life quality, suppressing airway eosinophilia and cough remission in NAEB.

Methods: A prospective, open-labeled, multicenter, randomized controlled trial was conducted. Patients with NAEB (aged 18-75 years) were randomized to inhaled BUD (200 μg, bid) or BUD plus oral MONT (10 μg, qn) for 4 weeks. Leicester cough questionnaire (LCQ) life quality scores, cough visual analog scale (CVAS) scores, eosinophil differential ratio (Eos), and eosinophil cationic protein (ECP) in induced sputum were monitored and compared.

Results: The control and MONT groups contained 33 and 32 patients, respectively, with similar baseline characteristics. Significant with-in group improvement in CVAS, LCQ scores, Eos, and ECP was observed in both groups during treatment. After 2-week treatment, add-on treatment of MONT was significantly more effective than BUD monotherapy for CVAS decrease and LCQ scores improvement (both P < 0.05). Similar results were seen at 4-week assessment (both P < 0.05). 4-week add-on therapy of MONT also resulted in a higher percentage of patients with normal sputum Eos (<2.5%) and greater decrease of ECP (both P < 0.05).

Conclusions: MONT combined with BUD was demonstrated cooperative effects in improvement of life quality, suppression of eosinophilic inflammation, and cough remission in patients with NAEB.

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Related in: MedlinePlus

Flowchart summarizing the study protocol. Nonasthmatic eosinophilic bronchitis; leicester cough questionnaire; cough visual analogue scale; Eos: Eosinophil differential count in induced sputum; eosinophil cationic protein.
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Figure 1: Flowchart summarizing the study protocol. Nonasthmatic eosinophilic bronchitis; leicester cough questionnaire; cough visual analogue scale; Eos: Eosinophil differential count in induced sputum; eosinophil cationic protein.

Mentions: After inclusion, patients were assessed at three separate visits: Visit 1, before starting therapy; visit 2, 2 weeks after the start of therapy; visit 3, 4 weeks after the start of therapy [Figure 1]. At each visit, physical examination, clinical response assessments, and adherence to therapy were recorded.


Efficacy of add-on montelukast in nonasthmatic eosinophilic bronchitis: the additive effect on airway inflammation, cough and life quality.

Bao W, Liu P, Qiu Z, Yu L, Hang J, Gao X, Zhou X - Chin. Med. J. (2015)

Flowchart summarizing the study protocol. Nonasthmatic eosinophilic bronchitis; leicester cough questionnaire; cough visual analogue scale; Eos: Eosinophil differential count in induced sputum; eosinophil cationic protein.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4837817&req=5

Figure 1: Flowchart summarizing the study protocol. Nonasthmatic eosinophilic bronchitis; leicester cough questionnaire; cough visual analogue scale; Eos: Eosinophil differential count in induced sputum; eosinophil cationic protein.
Mentions: After inclusion, patients were assessed at three separate visits: Visit 1, before starting therapy; visit 2, 2 weeks after the start of therapy; visit 3, 4 weeks after the start of therapy [Figure 1]. At each visit, physical examination, clinical response assessments, and adherence to therapy were recorded.

Bottom Line: After 2-week treatment, add-on treatment of MONT was significantly more effective than BUD monotherapy for CVAS decrease and LCQ scores improvement (both P < 0.05).Similar results were seen at 4-week assessment (both P < 0.05). 4-week add-on therapy of MONT also resulted in a higher percentage of patients with normal sputum Eos (<2.5%) and greater decrease of ECP (both P < 0.05).MONT combined with BUD was demonstrated cooperative effects in improvement of life quality, suppression of eosinophilic inflammation, and cough remission in patients with NAEB.

View Article: PubMed Central - PubMed

Affiliation: Department of Respiratory Medicine, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai 200080, China.

ABSTRACT

Background: The efficacy of montelukast (MONT), a cysteinyl leukotriene receptor antagonist, in nonasthmatic eosinophilic bronchitis (NAEB), especially its influence on cough associated life quality is still indefinite. We evaluated the efficacy of MONT combined with budesonide (BUD) as compared to BUD monotherapy in improving life quality, suppressing airway eosinophilia and cough remission in NAEB.

Methods: A prospective, open-labeled, multicenter, randomized controlled trial was conducted. Patients with NAEB (aged 18-75 years) were randomized to inhaled BUD (200 μg, bid) or BUD plus oral MONT (10 μg, qn) for 4 weeks. Leicester cough questionnaire (LCQ) life quality scores, cough visual analog scale (CVAS) scores, eosinophil differential ratio (Eos), and eosinophil cationic protein (ECP) in induced sputum were monitored and compared.

Results: The control and MONT groups contained 33 and 32 patients, respectively, with similar baseline characteristics. Significant with-in group improvement in CVAS, LCQ scores, Eos, and ECP was observed in both groups during treatment. After 2-week treatment, add-on treatment of MONT was significantly more effective than BUD monotherapy for CVAS decrease and LCQ scores improvement (both P < 0.05). Similar results were seen at 4-week assessment (both P < 0.05). 4-week add-on therapy of MONT also resulted in a higher percentage of patients with normal sputum Eos (<2.5%) and greater decrease of ECP (both P < 0.05).

Conclusions: MONT combined with BUD was demonstrated cooperative effects in improvement of life quality, suppression of eosinophilic inflammation, and cough remission in patients with NAEB.

Show MeSH
Related in: MedlinePlus