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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

Eosinophil differential count (Eos) in induced sputum.(Panel A) Changes of Eos in induced sputum during 4 weeks treatment; and (Panel B) effects of 4-weeks add-on montelukast (MONT) treatment on Eos. Data are expressed as mean ± standard error. *P < 0.05, compared using Fish's exact test. Eos, eosinophil differential count in induced sputum; Mont., MONT; Bude, budesonide.
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Figure 4: Eosinophil differential count (Eos) in induced sputum.(Panel A) Changes of Eos in induced sputum during 4 weeks treatment; and (Panel B) effects of 4-weeks add-on montelukast (MONT) treatment on Eos. Data are expressed as mean ± standard error. *P < 0.05, compared using Fish's exact test. Eos, eosinophil differential count in induced sputum; Mont., MONT; Bude, budesonide.

Mentions: For patients in BUD group or MONT/BUD group, compared with baseline values (9.20 ± 6.65 vs. 11.42 ± 12.44), both treatments significantly reduced sputum eosinophils in the first 2 weeks (4.58 ± 2.35 vs. 5.25 ± 4.17; both P < 0.001, compared with baseline values) [Figure 4, Panel A]. There was no obviously additional reduction of sputum eosinophils between 2-week and 4 week in BUD group (3.27 ± 1.47 at 4-week, P > 0.05, compared with 2-week values). In contrast, add-on therapy of MONT was proved additional inhibition of eosinophilic inflammation in the last 2 weeks of treatment (2.89 ± 1.47 at 4-week, P < 0.05, compared with 2-week values). After 4 weeks treatment, percentage of patients with normal sputum eosinophils (<2.5%) in MONT/BUD group was higher than BUD group (51.52% vs. 25.00%, P = 0.0414) [Figure 4, Panel B], which also demonstrated the cooperative effects of MONT.


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)

Eosinophil differential count (Eos) in induced sputum.(Panel A) Changes of Eos in induced sputum during 4 weeks treatment; and (Panel B) effects of 4-weeks add-on montelukast (MONT) treatment on Eos. Data are expressed as mean ± standard error. *P < 0.05, compared using Fish's exact test. Eos, eosinophil differential count in induced sputum; Mont., MONT; Bude, budesonide.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 4: Eosinophil differential count (Eos) in induced sputum.(Panel A) Changes of Eos in induced sputum during 4 weeks treatment; and (Panel B) effects of 4-weeks add-on montelukast (MONT) treatment on Eos. Data are expressed as mean ± standard error. *P < 0.05, compared using Fish's exact test. Eos, eosinophil differential count in induced sputum; Mont., MONT; Bude, budesonide.
Mentions: For patients in BUD group or MONT/BUD group, compared with baseline values (9.20 ± 6.65 vs. 11.42 ± 12.44), both treatments significantly reduced sputum eosinophils in the first 2 weeks (4.58 ± 2.35 vs. 5.25 ± 4.17; both P < 0.001, compared with baseline values) [Figure 4, Panel A]. There was no obviously additional reduction of sputum eosinophils between 2-week and 4 week in BUD group (3.27 ± 1.47 at 4-week, P > 0.05, compared with 2-week values). In contrast, add-on therapy of MONT was proved additional inhibition of eosinophilic inflammation in the last 2 weeks of treatment (2.89 ± 1.47 at 4-week, P < 0.05, compared with 2-week values). After 4 weeks treatment, percentage of patients with normal sputum eosinophils (<2.5%) in MONT/BUD group was higher than BUD group (51.52% vs. 25.00%, P = 0.0414) [Figure 4, Panel B], which also demonstrated the cooperative effects of MONT.

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