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Does Dose Reduction of an Inhaled Corticosteroid with the Addition of Leukotriene Antagonist is Clinical Significance in Asthma Patients? A Randomized Clinical Trial

Asthma is an inflammatory disease characterized by recurrent episodes of breathlessness and wheezing. Though inhaled corticosteroids (ICS) play a vital role in the treatment of asthma, it has commendable side effects. Reduction of ICS dose with any other drug combination may therefore be of clinical significance. A total of 108 patients with mild to moderate asthma were enrolled in this randomized controlled study from respiratory medicine department of a tertiary care hospital. Patients were randomized into two groups viz., usual care (n=54) and intervention group (n=54). Usual care group patients received Budesonide. Patients in the intervention group received Montelukast with half of the dose of Budesonide. Pulmonary function test was assessed at the baseline and on follow up days. No significant difference was observed with respect to socioeconomic and educational status of patients between usual care and intervention group. Significant (P<0.01) improvement in FEV after 150 days treatment with Montelukast and half dose of steroid was observed. 1 There is no serious adverse drug reaction among the tested groups. The study concluded that dose reduction of an inhaled corticosteroid with the addition of leukotriene antagonist is clinically significant in asthma patients. The future studies may be directed towards extended duration of action.