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The Efficacy of the Leukotriene Receptor Antagonist Pranlukast in Asthma Patients Complicated with Allergic Rhinitis
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A1385 - The Efficacy of the Leukotriene Receptor Antagonist Pranlukast in Asthma Patients Complicated with Allergic Rhinitis
Author Block: T. Etsuko1, M. Toriyama1, H. Hara1, T. Hanawa1, K. Takeyama2, M. Kondo1, J. Tamaoki1; 1Tokyo Womens Medical University, Shinjuku,Tokyo, Japan, 2First Department of Medicine, Tokyo Women's Medical University, Shinjuku,Tokyo, Japan.
RATIONALE: Asthma and allergic rhinitis (AR) are very common comobidities, and the relationship between the two diseases fits the concept “one airway, one disease”. It has been reported that AR may also be an important risk factor for the development and severity of asthma. We therefore investigated the clinical impact of treatment with inhaled corticosteroid (ICS) or leukotriene receptor antagonist (LTRA) in patients with asthma complicated with AR.
METHODS: The study was a randomized, controlled, parallel-group trial, designed to evaluate the effectiveness of pranlukast, a LTRA, and high-dose ICS, in the treatment of asthma complicated with AR. We assessed the prevalence and severity of AR and asthma using the Allergic Rhinitis and its Impact on Asthma (ARIA) and VAS (Visual Analog Scale), respectively. We recruited asthma patients who had been treated with ICS, of which those with poorly controlled asthma complicated AR was assigned to add pranlukast (PK) to the treatment or doubling the dose of previous ICS for 12 weeks. We compared these two groups in terms of age, sex, ACT score, FeNO level, use of β2-agonist and pulmonary function.
RESULTS: Among 140 patients with asthma, 95 (68%) had AR. Judging from ACT score and pulmonary function, patients who had both asthma and AR were more severe than those with asthma only. In the treatment period, 43 patients with asthma and AR were enrolled, and 40 patients completed the trial and provided verifiable data (22 patients in the PK group and 18 patients in the ICS group). There were no significant differences in the baseline characteristics between the two groups. After the treatment of 4 and 12 weeks, the increase in FEV1 was greater in the PK group than in the ICS group. ACT score and FeNO level improved in the two groups with the same magnitudes. The VAS of both asthma and AR decreased in the PK group, whereas only VAS of asthma decreased in the ICS group.
CONCLUSIONS: About two-thirds of asthma patients had also AR, and asthma control was poor in such patients. Addition of LTRA seems to be more effective than doubling the dose of ICS for the treatment of asthma complicated with AR patients.
Author Block: T. Etsuko1, M. Toriyama1, H. Hara1, T. Hanawa1, K. Takeyama2, M. Kondo1, J. Tamaoki1; 1Tokyo Womens Medical University, Shinjuku,Tokyo, Japan, 2First Department of Medicine, Tokyo Women's Medical University, Shinjuku,Tokyo, Japan.
RATIONALE: Asthma and allergic rhinitis (AR) are very common comobidities, and the relationship between the two diseases fits the concept “one airway, one disease”. It has been reported that AR may also be an important risk factor for the development and severity of asthma. We therefore investigated the clinical impact of treatment with inhaled corticosteroid (ICS) or leukotriene receptor antagonist (LTRA) in patients with asthma complicated with AR.
METHODS: The study was a randomized, controlled, parallel-group trial, designed to evaluate the effectiveness of pranlukast, a LTRA, and high-dose ICS, in the treatment of asthma complicated with AR. We assessed the prevalence and severity of AR and asthma using the Allergic Rhinitis and its Impact on Asthma (ARIA) and VAS (Visual Analog Scale), respectively. We recruited asthma patients who had been treated with ICS, of which those with poorly controlled asthma complicated AR was assigned to add pranlukast (PK) to the treatment or doubling the dose of previous ICS for 12 weeks. We compared these two groups in terms of age, sex, ACT score, FeNO level, use of β2-agonist and pulmonary function.
RESULTS: Among 140 patients with asthma, 95 (68%) had AR. Judging from ACT score and pulmonary function, patients who had both asthma and AR were more severe than those with asthma only. In the treatment period, 43 patients with asthma and AR were enrolled, and 40 patients completed the trial and provided verifiable data (22 patients in the PK group and 18 patients in the ICS group). There were no significant differences in the baseline characteristics between the two groups. After the treatment of 4 and 12 weeks, the increase in FEV1 was greater in the PK group than in the ICS group. ACT score and FeNO level improved in the two groups with the same magnitudes. The VAS of both asthma and AR decreased in the PK group, whereas only VAS of asthma decreased in the ICS group.
CONCLUSIONS: About two-thirds of asthma patients had also AR, and asthma control was poor in such patients. Addition of LTRA seems to be more effective than doubling the dose of ICS for the treatment of asthma complicated with AR patients.
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