Comparison of inhaled salmeterol and oral zafirlukast in patients with asthma☆,☆☆,★
Section snippets
Study design and patients
This randomized, double-blind, double-dummy, parallel-group, multicenter clinical trial compared the efficacy and safety of inhaled salmeterol xinafoate (Serevent; Glaxo Wellcome Inc, Research Triangle Park, NC) at a dose of 42 μg twice daily (2 puffs), administered by means of a metered-dose inhaler, with oral zafirlukast (Accolate; Zeneca Pharmaceuticals, Wilmington, Del) at a dose of 20 mg twice daily over a 4-week treatment period in adolescents and adults with persistent asthma. This study
Demographics
A total of 144 patients received inhaled salmeterol and 145 received oral zafirlukast in this trial. Demographic and baseline disease characteristics were similar in the 2 treatment groups (Table I)Approximately 80% of the patients in each treatment group were on a stable regimen of ICSs.
Pulmonary function
PEF. Baseline morning and evening PEF were comparable between the 2 groups (371.8 and 392.1 L/min, respectively, in the salmeterol group; 368.5 and 398.3 L/min, respectively, in the zafirlukast group).
DISCUSSION
This study is the first to compare a leukotriene receptor antagonist to a long-acting β-agonist. Previous studies have characterized the efficacy of zafirlukast in patients with mild-to-moderate persistent asthma who were not using concomitant inhaled steroids.2, 3, 4 The effects of zafirlukast in a patient population that is heterogeneous with regard to ICS use have not been studied. The current study included patients who were and patients who were not using ICSs. This was an appropriate
Acknowledgements
We thank Amanda Emmett for her assistance in performing the statistical analyses for this study and Larry East for his expert assistance in the preparation of this manuscript.
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Current state and future prospect of the therapeutic strategy targeting cysteinyl leukotriene metabolism in asthma
2019, Respiratory InvestigationCitation Excerpt :However, a systematic review and meta-analysis reported that the effects of LTRAs were inferior to those of a long-acting β2 agonist (LABA) when used along with ICS for controlling respiratory symptoms and asthma attacks [75]. Thus, the priority to select LTRAs as add-on drugs is not necessarily high at present, even though LTRAs possess superior anti-inflammatory effects in reducing blood inflammatory markers, including eosinophils [75–77]. Currently, combined inhalation of ICS and LABA (ICS/LABA) is highly effective and easy-to-use for enhancing patient compliance to therapy, and is thus considered with the highest priority in long-term asthma treatment for patients with moderate to severe asthma.
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Supported by Glaxo Wellcome Inc, Research Triangle Park, NC.
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Reprint requests: William Busse, MD, University of Wisconsin-Madison Medical School, Department of Medicine, 15/220 Clinical Science Center 600 Highland Avenue, Madison, WI 53792-2454.
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