Montelukast as add-on therapy to asthma treatment improves symptom control and quality of life
The Pharmacological Guide to Montelukast, NOVA Publications , ss.19-88, 2020
- Yayın Türü: Kitapta Bölüm / Araştırma Kitabı
- Basım Tarihi: 2020
- Yayınevi: NOVA Publications
- Sayfa Sayıları: ss.19-88
- Anahtar Kelimeler: ACT, AQLQ, Asthma, Montelukast, Quality of life, Symptom control
- Lokman Hekim Üniversitesi Adresli: Evet
Özet
Introduction: Asthma like other chronic diseases affects the physical, emotional and social aspects of a patient's life. Thus, the impact of new treatment modalities is needed to be assessed in terms of both clinical and humanistic outcomes. The aim of this study is to assess the impact of addition of montelukast to the ongoing asthma treatment in terms of improvement in clinical parameters, symptom control and quality of life (QOL). Methods: The subjects (n=50) consisted of asthma patients aged between 18-65 years, who were not receiving a leukotriene receptor antagonist and who accepted to participate in the study on admittance to the outpatient asthma clinic where the study was conducted. These patients were receiving inhaled corticosteroid (ICS) w/wo long-acting beta2-adrenoceptor agonist (LABA) [+ rapid onset bronchodilator prn] as their maintenance therapies. At the initial visit, the baseline clinical, medication-related and QOL data were recorded and montelukast was added to their therapies. The patients were followed-up for three months and at the final visit, the clinical data as presented by FEV1%, disease severity, symptom control status and the QOL data were recorded again and analyzed for any improvement through the 3-month period. Disease severity was graded according to the Global Initiative for Asthma (GINA) guidelines. Asthma Control Test (ACT) was used in order to assess the symptom control. Asthma Quality of Life Questionnaire (AQLQ) was used to assess the asthma-related QOL of the patients. Results: Mean (SEM) age of the patients was 38.6 (1.7) and 80% of the patients was female. The medications used for maintenance asthma treatment other than montelukast were high-dose ICS w/LABA (26%), moderate-dose ICS w/wo LABA (40%/8%) and low-dose ICS w/wo LABA (16%/10%). Addition of montelukast resulted in improvement in disease severity (rate of uncontrolled patients decreased from 86% to 50%, p<0.05); improved symptom control: (median [min-max] ACT score increased from 13 [5-25] to 19.5 [10-25], p<0.001); improved QOL: (median [min-max] AQLQ score increased from 104.5 [45-213] to 156.5 [74-224], p<0.001); while similar improvements were observed for all domains of the AQLQ. The mean (SEM) FEV1 increased from 73.08% (2.1%) to 87.15% (1.6%) at the end of three-months (p<0.001). Conclusion: Addition of montelukast to the ongoing asthma treatment resulted in favorable outcomes in terms of improved disease severity, symptom control and QOL.