Effectiveness and Quality of Life with Montelukast in Asthma Patients
Asthma, a highly prevalent chronic
inflammatory disease of the airways, is characterized by a variable degree of
airflow obstruction, edema, and bronchial hyper responsiveness caused by
chronic exposition to allergens or associated to other diseases such as gastro
esophageal reflux.
The complex genetic actions and
environmental triggers intricately interchange; making asthma a multifactorial
syndrome of a broad array of variable phenotypes and manifestations.
Chronic airway inflammation substantially contributes to airflow limitation, respiratory symptoms, and disease chronicity. Crucial players in the development of chronic airway inflammation in asthma are airway structural cells and immune cells infiltrating the lung (T cells and eosinophils) which are pivotal sources of inflammatory mediators such as leukotrienes (LT).
TAKE HOME MESSAGE:
The aim of this study is to
understand the role of montelukast in asthma control and QOL of asthmatic
individuals.
Even though the gold standard of
long-term asthma care is inhaled corticosteroid (ICS); LTRAs have their
advantage of easy oral dose, and reducing long-term side effects of ICS. Current
Global Initiative for Asthma (GINA) guidelines recommend LTRAs as a monotherapy
in mild persistent asthma, as an add-on or alternative to increasing dose of
ICS or adding a long-acting β2-agonist.
Role of montelukast in controlling
asthma and improving the quality of life (QOL) of asthmatic patients has been
experimented.
The results of this trial show that
OD treatment with 10mg montelukast, in comparison to placebo, resulted in
significant improvement in quality of life over a period of four weeks.
CONCLUSION
The role of montelukast in
improving quality of life (QOL) of adult patients with mild to moderate
persistent asthma is quite beneficial. It improves patient quality of life. It
has the ease of once daily oral administration and also eradicates side effects
associated with long-term adherence to steroids.
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Objective:
To determine the role of montelukast
– a leukotriene receptor antagonist (LTRA) – in improving the quality of life
(QOL) and asthma control of adult patients with mild to moderate persistent
asthma.
Methods:
Randomized, double-blind,
placebo-controlled, non-crossover trial was conducted from March 2017 till
November 2018 in three hospitals of Karachi and Hyderabad. Adults of age 15
years or more with mild to moderate persistent asthma. Treatment group was
administered tablet montelukast 10mg once daily; the other group was given a similar
looking placebo; as an adjuvant to the current medication. QOL was assessed
with Asthma Quality of Life Questionnaire – Standard (AQLQ-S) before and after
the treatment. Asthma control was monitored via Asthma Control Test (ACT).
Results:
After 4 weeks, the mean ± SD of
overall QOL on AQLQ-S improved from 3.74±0.88 to 5.06±0.89 for montelukast
group and from 3.58±0.92 to 4.71±0.97 for placebo group. The improvement in
sub-domains of symptoms, activity, and emotional functions was not significant;
however, the sub-domain “environmental stimuli” significantly improved with
5.06±0.89 for montelukast group and 4.71±0.97 for placebo group. The mean ± SD
of ACT, after four weeks, for montelukast group was 18.19±2.91 and for placebo
group 17.28±3.36. Only on ACT, Montelukast did not show any statistically
insignificant results.
Conclusion:
The role of montelukast in
improving QOL of adult patients with mild to moderate persistent asthma is
quite beneficial. It improves patient quality of life. It has the ease of once
daily oral administration and also eradicates side effects associated with long-term
adherence to steroids.
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