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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 cationic protein (ECP) in supernatant of induced sputum. (Panel A) Changes of ECP during 4 weeks treatment; and (Panel B) effects of 4-weeks add-on montelukast treatment on decrease of ECP (%). Data are expressed as mean ± standard error (Panel A) or median (10–90% range) (Panel B). *P < 0.05, compared using Mann-Whitney test ECP.
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Figure 5: Eosinophil cationic protein (ECP) in supernatant of induced sputum. (Panel A) Changes of ECP during 4 weeks treatment; and (Panel B) effects of 4-weeks add-on montelukast treatment on decrease of ECP (%). Data are expressed as mean ± standard error (Panel A) or median (10–90% range) (Panel B). *P < 0.05, compared using Mann-Whitney test ECP.

Mentions: The reductions of eosinphils and ECP were in parallel with the treatment course. For patients in BUD group or MONT/BUD group, compared with baseline values (2.28 ± 0.46 vs. 2.32 ± 0.45, log [μg/L]), both treatments significantly reduced sputum ECP in the first 2 weeks (1.82 ± 0.48 vs. 1.87 ± 0.42; both P < 0.001, compared with baseline values) [Figure 5, Panel A]. Additional improvement was proved in analyzing sputum ECP for both groups at 4-week (for BUD group, 1.35 ± 0.34, P < 0.05; for MONT/BUD group, 1.16 ± 0.44, P < 0.01; both compared with ECP of 2-week). After 4 weeks treatment, add-on therapy of MONT was found to result in greater decrease of ECP compared with BUD group (1.17 ± 0.46 vs. 0.92 ± 0.39, P = 0.0454) [Figure 5, Panel B].


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 cationic protein (ECP) in supernatant of induced sputum. (Panel A) Changes of ECP during 4 weeks treatment; and (Panel B) effects of 4-weeks add-on montelukast treatment on decrease of ECP (%). Data are expressed as mean ± standard error (Panel A) or median (10–90% range) (Panel B). *P < 0.05, compared using Mann-Whitney test ECP.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 5: Eosinophil cationic protein (ECP) in supernatant of induced sputum. (Panel A) Changes of ECP during 4 weeks treatment; and (Panel B) effects of 4-weeks add-on montelukast treatment on decrease of ECP (%). Data are expressed as mean ± standard error (Panel A) or median (10–90% range) (Panel B). *P < 0.05, compared using Mann-Whitney test ECP.
Mentions: The reductions of eosinphils and ECP were in parallel with the treatment course. For patients in BUD group or MONT/BUD group, compared with baseline values (2.28 ± 0.46 vs. 2.32 ± 0.45, log [μg/L]), both treatments significantly reduced sputum ECP in the first 2 weeks (1.82 ± 0.48 vs. 1.87 ± 0.42; both P < 0.001, compared with baseline values) [Figure 5, Panel A]. Additional improvement was proved in analyzing sputum ECP for both groups at 4-week (for BUD group, 1.35 ± 0.34, P < 0.05; for MONT/BUD group, 1.16 ± 0.44, P < 0.01; both compared with ECP of 2-week). After 4 weeks treatment, add-on therapy of MONT was found to result in greater decrease of ECP compared with BUD group (1.17 ± 0.46 vs. 0.92 ± 0.39, P = 0.0454) [Figure 5, Panel B].

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