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首页> 外文期刊>Clinical and experimental allergy : >Add-on montelukast to inhaled corticosteroids protects against excessive airway narrowing.
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Add-on montelukast to inhaled corticosteroids protects against excessive airway narrowing.

机译：吸入皮质类固醇补充孟鲁司特可防止气道过度狭窄。

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RATIONALE: Excessive airway narrowing in response to broncho-active stimuli is a predictor for severe exacerbations in asthma. Leukotriene receptor antagonists (LTRAs) have complementary properties to inhaled corticosteroids (ICS) on asthma control. OBJECTIVES: The LTRA montelukast may provide an additional protection against excessive airway narrowing. We tested the add-on effects of montelukast on the maximal response plateau and PD(20) to inhaled methacholine in asthmatics on a stable dose of ICS. METHODS: Thirty-one patients with allergic asthma [14M/17F, 19-50 years, forced expiratory volume in 1 s (FEV(1)) >70% pred., PD(20) <3.9 micromol methacholine], with a twice documented response plateau to methacholine, were randomized in a double-blind (montelukast 10 mg or matching placebo once daily), 12-week parallel study. Bronchoprovocation tests with methacholine (0.03-256 micromol or > or =40% decline in FEV(1)) were repeated every 4 weeks and after wash-out. The main study objectives were changes from baseline in maximal FEV(1) decline at the response plateau (i.e. >2 post-dose FEV(1) values within 5%) and PD(20) to methacholine after 12 weeks' treatment. RESULTS: Neither treatment affected baseline FEV(1) (P=0.62). Compared with placebo, montelukast significantly decreased the maximal response plateau to methacholine (mean difference 9.4%; 95% confidence interval 3.9-15.7; P<0.005), improved the FEV(1) decline (mean change in FEV(1) decline was 2.1% [montelukast] and -0.8% [placebo], respectively, P<0.05), and increased PD(20) methacholine (mean change in PD(20) of 5.3 [montelukast] and 1.4 [placebo] doubling doses, respectively, P<0.001). CONCLUSION: Add-on montelukast to ICS has disease-modifying effects in adults with persistent asthma, and hence reduces the risk of excessive airway narrowing (NCT 00913328).
机译：理由：支气管活动性刺激引起的过度气道狭窄是哮喘严重加重的预测因素。在哮喘控制上，白三烯受体拮抗剂（LTRAs）与吸入皮质类固醇（ICS）具有互补性。目的：LTRA孟鲁司特可以提供额外的保护，以防止过度的气道狭窄。我们在稳定剂量的ICS上测试了孟鲁司特对最大反应平稳期和PD（20）对吸入性乙酰甲胆碱在哮喘患者中的附加作用。方法：31例过敏性哮喘患者[14M / 17F，19-50岁，强制呼气量在1 s（FEV（1））> 70％pred。，PD（20）<3.9 micromol乙酰甲胆碱]，两次有记录的对乙酰甲胆碱的反应平台被随机分为一项双盲研究（孟鲁司特10 mg或每天一次的匹配安慰剂），为期12周的平行研究。每隔4周和冲刷后，用乙酰甲胆碱（0.03-256微摩尔或FEV（1）下降≥40％）进行支气管激发试验。主要研究目标是在治疗12周后从反应平台的最大FEV（1）下降的基线（即剂量后FEV（1）值> 2在5％之内）和PD（20）变为乙酰甲胆碱。结果：两种治疗均未影响基线FEV（1）（P = 0.62）。与安慰剂相比，孟鲁司特显着降低了对乙酰甲胆碱的最大反应平台（平均差异9.4％; 95％置信区间3.9-15.7; P <0.005），改善了FEV（1）下降（FEV（1）下降的平均变化为2.1）分别为[孟鲁司特]和-0.8％[安慰剂]，P <0.05），并增加了PD（20）乙酰甲胆碱（PD（20）的平均变化分别为5.3 [孟鲁司特]和1.4 [安慰剂]加倍剂量，P <0.001）。结论：ICS补充孟鲁司特对患有持续性哮喘的成年人具有改善疾病的作用，因此降低了过度气道狭窄的风险（NCT 00913328）。

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