Comparative efficacy of leukotriene modifier and inhaled corticosteroids in the complex treatment of steroid-naive patients with bronchial asthma combined with chronic obstructive pulmonary disease with neutrophilic type of inflammation

Authors

DOI:

https://doi.org/10.14739/2310-1210.2021.4.229508

Keywords:

bronchial asthma, chronic obstructive lung disease, treatment

Abstract

The aim: to compare the efficacy and tolerability of the leukotriene modifier and inhaled corticosteroids in combination with long-acting β2-agonist formoterol in steroid-naive patients with asthma combined with COPD with neutrophilic inflammation.

Materials and methods. After obtaining the written consent, 30 patients with asthma combined with COPD and a number of blood neutrophils >4000/μl were randomized (1:1): group I – received a fixed combination of budesonide/formoterol 160/4.5 μg/1 inhalation twice daily as a basic therapy; group II – montelukast 1 tab. (10 mg) once daily and inhalation of formoterol 12 mcg/dose twice daily. The duration of therapy was 12 weeks. General clinical methods, asthma control questionnaires, COPD questionnaire, physical tolerance evaluation (6-minute walk test), pulmonary function tests, quality of life assessment were performed to all the patients before and after the treatment course studied.

Results. The combination of budesonide/formoterol improved clinical symptoms – significantly (P < 0.05) increased the total ACT score, decreased the average ACQ score, shortness of breath (mMRC scale), COPD symptoms. PFT indices were improved significantly (P < 0.05), bronchoobstruction at the level of large, medium and small bronchi was significantly reduced. Physical tolerance was significantly improved. There were no statistically significant dynamics of the studied indices in patient group II. The patients of both groups showed a tendency to improve their quality of life. In patients of I group, there was a significant decrease in activity limitations and the total SGRQ score.

Conclusions. The combination of inhaled corticosteroid/formoterol has proven to be more effective than the leukotriene modifier or formoterol in steroid-naive patients with asthma combined with COPD and neutrophilic inflammation.

Author Biographies

Yu. I. Feshchenko, SI “National Institute of Phthisiology and Pulmonology named after F. H. Yanovskyi NAMS of Ukraine”, Kyiv

MD, PhD, DSc, Professor, Academician of NAMS of Ukraine, Director

L. O. Yashyna, SI “National Institute of Phthisiology and Pulmonology named after F. H. Yanovskyi NAMS of Ukraine”, Kyiv

MD, PhD, DSc, Professor, Head of the Department of Diagnostic, Therapy and Clinical Pharmacology of Lung Diseases

V. I. Ihnatieva, SI “National Institute of Phthisiology and Pulmonology named after F. H. Yanovskyi NAMS of Ukraine”, Kyiv

PhD, Senior Researcher of the Department of Diagnostic, Therapy and Clinical Pharmacology of Lung Diseases

M. O. Polianska, SI “National Institute of Phthisiology and Pulmonology named after F. H. Yanovskyi NAMS of Ukraine”, Kyiv

MD, PhD, Senior Researcher of the Department of Diagnostic, Therapy and Clinical Pharmacology of Lung Diseases

S. H. Opimakh, SI “National Institute of Phthisiology and Pulmonology named after F. H. Yanovskyi NAMS of Ukraine”, Kyiv

MD, PhD, Senior Researcher of the Department of Diagnostic, Therapy and Clinical Pharmacology of Lung Diseases

I. V. Zvol, SI “National Institute of Phthisiology and Pulmonology named after F. H. Yanovskyi NAMS of Ukraine”, Kyiv

MD, PhD, Senior Researcher of the Department of Diagnostic, Therapy and Clinical Pharmacology of Lung Diseases

S. M. Moskalenko, SI “National Institute of Phthisiology and Pulmonology named after F. H. Yanovskyi NAMS of Ukraine”, Kyiv

MD, PhD, Senior Researcher of the Department of Diagnostic, Therapy and Clinical Pharmacology of Lung Diseases

H. L. Humeniuk, SI “National Institute of Phthisiology and Pulmonology named after F. H. Yanovskyi NAMS of Ukraine”, Kyiv

MD, PhD, DSc, Senior Researcher of the Department of Diagnostic, Therapy and Clinical Pharmacology of Lung Diseases

N. A. Vlasova, SI “National Institute of Phthisiology and Pulmonology named after F. H. Yanovskyi NAMS of Ukraine”, Kyiv

MD, Head of the Department of Differential Diagnostic of Tuberculosis and Non-specific Lung Diseases

L. A. Halai, SI “National Institute of Phthisiology and Pulmonology named after F. H. Yanovskyi NAMS of Ukraine”, Kyiv

MD, Pulmonologist of the Department of Differential Diagnostic of Tuberculosis and Non-specific Lung Diseases

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Published

2021-07-01

How to Cite

1.
Feshchenko YI, Yashyna LO, Ihnatieva VI, Polianska MO, Opimakh SH, Zvol IV, Moskalenko SM, Humeniuk HL, Vlasova NA, Halai LA. Comparative efficacy of leukotriene modifier and inhaled corticosteroids in the complex treatment of steroid-naive patients with bronchial asthma combined with chronic obstructive pulmonary disease with neutrophilic type of inflammation. Zaporozhye medical journal [Internet]. 2021Jul.1 [cited 2024Apr.25];23(4):516-23. Available from: http://zmj.zsmu.edu.ua/article/view/229508

Issue

Vol. 23 No. 4 (2021)

Section

Original research

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