מתוך medicontext.co.il
By David Douglas
WESTPORT, CT (Reuters Health) – Therapy with the inhaled corticosteroid fluticasone propionate appears to effectively diminish levels of fractional exhaled nitric oxide (FENO) in certain asthmatics, whereas use of the leukotriene receptor antagonist zafirlukast does not, according to Florida researchers.
In fact, lead author, Dr. Miguel J. Lanz told Reuters Health, that this "clinical study is the first to show that low-dose inhaled fluticasone reduces FENO, a marker of airway inflammation, in asthmatics significantly more than oral zafirlukast." Furthermore, he noted, "quality of life measures…were improved" by fluticasone treatment.
Dr. Lanz and colleagues at the Pan American Hospital Asthma and Allergy Center, Coral Gables, conducted a double-blind crossover study of 18 asthmatics who were not using anti-inflammatory medication. The findings were published in the October issue of the Annals of Allergy, Asthma, and Immunology.
The subjects were randomized to 4 weeks of treatment with fluticasone 88 µg twice daily or to placebo. A subset of 8 patients were then randomized to 4 weeks of treatment with zafirlukast 20 mg twice daily or to placebo.
Fluticasone treatment led to a significant reduction in exhaled NO and improvement in lung function (FEV1), spirometry, quality of life and asthma scores and use of rescue medication.
Zafirlukast treatment did not lead to significant reduction in exhaled NO, although asthma scores were reduced, as was use of rescue medication. In addition, after zafirlukast washout and entry into the second placebo phase, exhaled NO increased "to near prestudy levels."
Exhaled NO levels, the researchers conclude, "reveal an improvement with anti-inflammatory medication and worsening when it is discontinued."
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