Effect of montelukast on lung function in asthma patients with allergic rhinitis: analysis from the COMPACT trial

David Brendan Price, A. Swern, A. Tozzi, G. Philip, P. Polos

Research output: Contribution to journalArticle

95 Citations (Scopus)

Abstract

Background: The Clinical Outcomes with Montelukast as a Partner Agent to Corticosteroid Therapy (COMPACT) trial demonstrated that montelukast added to budesonide (MNT + BD) was as efficacious as double the dose of budesonide (dBD) in improving morning peak expiratory flow (AM PEF) in adult asthmatics. Recent studies have demonstrated that montelukast is also effective in treating daytime and nighttime allergic rhinitis (AR) symptoms in asthmatic patients. This analysis was designed to examine whether asthmatic patients with comorbid AR respond differently than patients without comorbid AR in terms of asthma control (lung function).

Methods: There were 216 asthmatic patients in the MNT + BD group and 184 patients in the dBD group with AR. Treatment differences in the change from baseline in AM PEF were compared. Least square (LS) mean and 95% confidence interval (CI) were derived from an ANOVA model adjusting for baseline and study site.

Results: There was a 9.2% increase in AM PEF from baseline in the MNT + BD group compared with a 6% increase in the dBD group. The LS mean difference [(MNT + BD) - dBD] was 14.2 l/min (P = 0.028). Other secondary endpoints were similar between groups.

Conclusion: In the subgroup of asthmatic patients with AR, a combined treatment approach that included montelukast and budesonide provided significantly greater efficacy in reducing airflow obstruction compared with doubling the dose of budesonide. These results support recommendations by the Allergic Rhinitis and its Impact on Asthma initiative that suggest a unified approach aimed at treating the airway inflammation common to both diseases is beneficial for the large proportion of asthmatics who also suffer from AR.

Original languageEnglish
Pages (from-to)737-742
Number of pages5
JournalAllergy
Volume61
DOIs
Publication statusPublished - Jun 2006

Keywords

  • inhaled corticosteroids
  • leukotrienes
  • peak expiratory flow
  • post hoc analysis
  • RANDOMIZED CONTROLLED-TRIAL
  • DOUBLE-BLIND
  • INFLAMMATION
  • MULTICENTER
  • PROVOCATION
  • EXPOSURE
  • AIRWAYS

Cite this

Effect of montelukast on lung function in asthma patients with allergic rhinitis: analysis from the COMPACT trial. / Price, David Brendan; Swern, A.; Tozzi, A.; Philip, G.; Polos, P.

In: Allergy, Vol. 61, 06.2006, p. 737-742.

Research output: Contribution to journalArticle

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abstract = "Background: The Clinical Outcomes with Montelukast as a Partner Agent to Corticosteroid Therapy (COMPACT) trial demonstrated that montelukast added to budesonide (MNT + BD) was as efficacious as double the dose of budesonide (dBD) in improving morning peak expiratory flow (AM PEF) in adult asthmatics. Recent studies have demonstrated that montelukast is also effective in treating daytime and nighttime allergic rhinitis (AR) symptoms in asthmatic patients. This analysis was designed to examine whether asthmatic patients with comorbid AR respond differently than patients without comorbid AR in terms of asthma control (lung function).Methods: There were 216 asthmatic patients in the MNT + BD group and 184 patients in the dBD group with AR. Treatment differences in the change from baseline in AM PEF were compared. Least square (LS) mean and 95{\%} confidence interval (CI) were derived from an ANOVA model adjusting for baseline and study site.Results: There was a 9.2{\%} increase in AM PEF from baseline in the MNT + BD group compared with a 6{\%} increase in the dBD group. The LS mean difference [(MNT + BD) - dBD] was 14.2 l/min (P = 0.028). Other secondary endpoints were similar between groups.Conclusion: In the subgroup of asthmatic patients with AR, a combined treatment approach that included montelukast and budesonide provided significantly greater efficacy in reducing airflow obstruction compared with doubling the dose of budesonide. These results support recommendations by the Allergic Rhinitis and its Impact on Asthma initiative that suggest a unified approach aimed at treating the airway inflammation common to both diseases is beneficial for the large proportion of asthmatics who also suffer from AR.",
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T1 - Effect of montelukast on lung function in asthma patients with allergic rhinitis: analysis from the COMPACT trial

AU - Price, David Brendan

AU - Swern, A.

AU - Tozzi, A.

AU - Philip, G.

AU - Polos, P.

PY - 2006/6

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N2 - Background: The Clinical Outcomes with Montelukast as a Partner Agent to Corticosteroid Therapy (COMPACT) trial demonstrated that montelukast added to budesonide (MNT + BD) was as efficacious as double the dose of budesonide (dBD) in improving morning peak expiratory flow (AM PEF) in adult asthmatics. Recent studies have demonstrated that montelukast is also effective in treating daytime and nighttime allergic rhinitis (AR) symptoms in asthmatic patients. This analysis was designed to examine whether asthmatic patients with comorbid AR respond differently than patients without comorbid AR in terms of asthma control (lung function).Methods: There were 216 asthmatic patients in the MNT + BD group and 184 patients in the dBD group with AR. Treatment differences in the change from baseline in AM PEF were compared. Least square (LS) mean and 95% confidence interval (CI) were derived from an ANOVA model adjusting for baseline and study site.Results: There was a 9.2% increase in AM PEF from baseline in the MNT + BD group compared with a 6% increase in the dBD group. The LS mean difference [(MNT + BD) - dBD] was 14.2 l/min (P = 0.028). Other secondary endpoints were similar between groups.Conclusion: In the subgroup of asthmatic patients with AR, a combined treatment approach that included montelukast and budesonide provided significantly greater efficacy in reducing airflow obstruction compared with doubling the dose of budesonide. These results support recommendations by the Allergic Rhinitis and its Impact on Asthma initiative that suggest a unified approach aimed at treating the airway inflammation common to both diseases is beneficial for the large proportion of asthmatics who also suffer from AR.

AB - Background: The Clinical Outcomes with Montelukast as a Partner Agent to Corticosteroid Therapy (COMPACT) trial demonstrated that montelukast added to budesonide (MNT + BD) was as efficacious as double the dose of budesonide (dBD) in improving morning peak expiratory flow (AM PEF) in adult asthmatics. Recent studies have demonstrated that montelukast is also effective in treating daytime and nighttime allergic rhinitis (AR) symptoms in asthmatic patients. This analysis was designed to examine whether asthmatic patients with comorbid AR respond differently than patients without comorbid AR in terms of asthma control (lung function).Methods: There were 216 asthmatic patients in the MNT + BD group and 184 patients in the dBD group with AR. Treatment differences in the change from baseline in AM PEF were compared. Least square (LS) mean and 95% confidence interval (CI) were derived from an ANOVA model adjusting for baseline and study site.Results: There was a 9.2% increase in AM PEF from baseline in the MNT + BD group compared with a 6% increase in the dBD group. The LS mean difference [(MNT + BD) - dBD] was 14.2 l/min (P = 0.028). Other secondary endpoints were similar between groups.Conclusion: In the subgroup of asthmatic patients with AR, a combined treatment approach that included montelukast and budesonide provided significantly greater efficacy in reducing airflow obstruction compared with doubling the dose of budesonide. These results support recommendations by the Allergic Rhinitis and its Impact on Asthma initiative that suggest a unified approach aimed at treating the airway inflammation common to both diseases is beneficial for the large proportion of asthmatics who also suffer from AR.

KW - inhaled corticosteroids

KW - leukotrienes

KW - peak expiratory flow

KW - post hoc analysis

KW - RANDOMIZED CONTROLLED-TRIAL

KW - DOUBLE-BLIND

KW - INFLAMMATION

KW - MULTICENTER

KW - PROVOCATION

KW - EXPOSURE

KW - AIRWAYS

U2 - 10.1111/j.1398-9995.2006.01007.x

DO - 10.1111/j.1398-9995.2006.01007.x

M3 - Article

VL - 61

SP - 737

EP - 742

JO - Allergy

JF - Allergy

SN - 0105-4538

ER -