Comparative Study of add-on Therapies, Salmeterol and Montelukast to Inhaled Corticosteroids in Mild to Moderate Asthmatic Patients

Abstract

Objective: The aim of this study was to compare the effect of both add-on therapies; Salmeterol plus Inhaled Corticosteroid and Montelukast and Inhaled Corticosteroid on asthma control in poorly controlled asthma.

Study Design: Randomized clinical trial.

Place and Duration of Study: Department of Pharmacology and Therapeutics, Basic Medical Sciences Institute, Jinnah Post-graduate Medical Centre, Karachi from December 2007 to June 2008.

Materials and Methods: 75 patients aged between 15-65 years, suffering from mild to moderate asthma were randomly divided in three groups. Group A was given Salmeterol 50µg and Fluticasone propionate 250µg twice daily, Group B was given tablet Montelukast 10mg at night in addition to Beclomethasone Dipropionate 500µg twice daily and Group C was given  Beclomethasone Dipropionate 500µg twice daily. Improvements in Peak Expiratory Flow Rate (PEFR) and FEV₁ were assessed by Peak Expiratory Flow Meter and Spirometry, fortnightly at the beginning and end of treatment respectively. Student paired t test was applied to analyze data.

Results: An improvement of 46.58 %( P-value <0.001), 38.59% (P-value <0.005) and 21.2% (P-value not significant) in PEFR was noted in Group A, B and C respectively. In Group A and B FEV₁ increased from1.17L/min (±0.12) to 1.41L/min (±0.13), and 1.42L/min (±0.13) to 1.62L/min (±0.13) respectively, while in Group C it was from 1.24L/min (±0.12) to 1.26L/min (±0.13). 

Conclusion: Salmeterol is slightly more effective than Montelukast as add-on treatment in increasing PEFR in patients suffering from mild to moderate persistent asthma.