Role of leukotriene receptor antagonist in the treatment of asthma in adutts

Abstract

Leukotrienes are a group of many substances which may be responsible for the effects of an inflammatory response. A randomized, double-blind, placebo-controlled, clinical trial, prospective study compared the clinical effect of oral leukotriene receptor antagonist groups (Montelukast, and Zafirlukast) and placebo group in the management of mild and moderate bronchial asthma. A total of 150 patients (84 females, and 66 males) with mild to moderate asthma were included in this study, their age range between 15 to 70 years. The study was conducted in A1-Sherqat general hospital during the period from January to the August/ 2008. After history taken, all patients under-gone complete general examination, and chest examination. Measurement of height and peak expiratory flow rates (PEFR) and compared to the predicted average normal PEFR (liter/minute) to make sure that the patient had mild-moderate asthma according to
classification of asthma severity (13). Two and half milliters of venous blood sample were obtained from basalic vein in the anticubital fossa of each patient included in the study by using disposable syringe after sterilization by 70% alcohol, this sample of blood was collected in a tube containing an anticoagulant (EDTA tube) for measurement of white blood cell count, ESR, & eosinophil count. Those patients were followed up after 1 month and after 3 months from the first visit. In each visit, measurement of PEFR, asthma symptoms score, eosinophils level, ESR, and WBC were done. One hundred fifty patients entered first period (l), 50 patients received montelukast, 50 patients received zafirlukast, and 50 patients received placebo. 76% of patients who received placebo complete period (l ,2), 78% of patients who received montelukast complete first & second period (1,2), and 84% of patients who received zafirlukast complete the first & second period (1,2) fig. (l). The discontinuation rate was higher in the placebo 24% than the
zafirlukast 16%, and montelukast 22%. The result of the group treated with montelukast regarding gender distribution show that about 44% were males and 56% were females. While group treated with placebo show that 54% were male and 46% were female, and group treated with zafirlukast show that about 36% were males and 64% were females. Asthmatic patients were treated with Montelukast significantly reduced eosinophil count from 0.38 before treatment to 0.33 after 1 month from starting treatment and 0.26 after 3 months. While there is a non significant difference in decrease of eosinophil counts after I month between zafirlukast and placebo.