Fluticasone or montelukast for preschool children with asthma-like symptoms: Randomized controlled trial

E. Kooi, S. Schokker, M.H. Boezen, T.W. de Vries, A.A. Vaessen - Verberne, T. van der Molen, E.J. Duiverman

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Abstract

RATIONALE: Beneficial effects of anti-inflammatory therapy such as fluticasone propionate (FP) and montelukast (Mk) have been demonstrated in preschool children with asthma. However, comparative studies are lacking in this age group. Therefore, we conducted a study to evaluate and compare the effect of FP and Mk in preschool children with asthma-like symptoms. METHODS: In this multicenter, randomized, placebo-controlled, double-blind, double-dummy trial, children aged 2-6 years with asthma-like symptoms were included. In total, 63 children were randomly allocated to receive FP (25), Mk (18) or placebo (20) for 3 months. The primary outcome was the daily symptom score (wheeze, cough, shortness of breath) as recorded by caregivers in a symptom diary card. Secondary endpoints were rescue medication free days, blood eosinophils and lung function (interrupter technique and forced oscillation technique (FOT)). RESULTS: During the 3 months study period, symptoms improved in all 3 groups, with a statistically significant difference between FP and placebo in favor of the FP group (p=0.021). A significant reduction in circulating eosinophils after 3 months of treatment was found in the Mk group only (p=0.008), which was significantly different from the change found in the placebo group (p=0.045). With the exception of frequency dependence (measured by FOT), which showed a difference between FP and Mk after 3 months of treatment in favor of the FP group (p=0.048), no differences in lung function within or between groups were found. CONCLUSIONS: In spite of a lack of power, our results suggest that FP has a beneficial effect on symptoms and Mk on blood eosinophil level as compared to placebo. Except for a difference in one lung function parameter after 3 months between FP and Mk in favor of the FP group, this study revealed no differences between FP and Mk.
Original languageEnglish
Pages (from-to)798-804
JournalPulmonary Pharmacology & Therapeutics
Volume21
Issue number5
DOIs
Publication statusPublished - 1 Jan 2008

Cite this

Kooi, E., Schokker, S., Boezen, M. H., de Vries, T. W., Vaessen - Verberne, A. A., van der Molen, T., & Duiverman, E. J. (2008). Fluticasone or montelukast for preschool children with asthma-like symptoms: Randomized controlled trial. Pulmonary Pharmacology & Therapeutics, 21(5), 798-804. https://doi.org/10.1016/j.pupt.2008.06.004