Chest
Original Research: AsthmaImprovements in Distal Lung Function Correlate With Asthma Symptoms After Treatment With Oral Montelukast
Section snippets
Subjects
Nineteen subjects 18 to 60 years of age with asthma, as defined by the American Thoracic Society,11 were recruited for the study. Subjects were required to have had a diagnosis of asthma for at least 6 months, to demonstrate an increase in FEV1 or FVC of ≥ 200 mL and 12% after receiving therapy with an inhaled bronchodilator, or to have a provocative concentration of methacholine causing a 20% fall in FEV1 (PC20) of < 8 mg/mL. In addition, they were required to demonstrate a residual volume
Subjects
Nineteen subjects met inclusion criteria, and their baseline characteristics are presented in Table 1. The subjects were considered to have mild asthma when FEV1 was 83% predicted, TLC was 107% predicted, and the geometric mean of the PC20 was 0.79 mg/mL.
Lung Physiology
See Table 2 for a summary of lung function studies prior to each treatment period and the change with montelukast and placebo, respectively. The p values represent a comparison between the change in the variable while the patient was receiving
Discussion
This study demonstrates that therapy with montelukast significantly improves asthma symptoms as well as physiology in both the proximal and distal lung compartments. The improvement in more proximal lung physiology is reflected by improvements in sGaw, while the distal lung compartment improvements are perhaps best reflected by a reduction in RV. The FEV1, a global measure of airway function, reflects the physiology of both the proximal and distal lung compartments, the conditions of which were
Conclusion
In summary, we determined that the systemic delivery of montelukast, at doses used clinically for the treatment of asthma, improved proximal and distal lung function in patients with mild asthma, particularly in those patients with evidence of air trapping, as demonstrated by an increase in RV. These improvements in distal lung function correlated significantly with improvements in asthma symptoms. This finding may explain why, in the face of modest FEV1 improvements with montelukast therapy,
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Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).
Drs. Kraft, Irvin, and Wenzel have served as speakers and consultants for Merck, Inc. Dr. Cairns received salary support and has been a speaker for Merck, Inc. Dr. Ellison and Mr. Pak have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.
This research was supported by Merck, Inc.