Purpose: Insufficient data exist to evaluate the comparative effects of inhaled corticosteroids versus leukotriene receptor antagonists on airway inflammation and remodelling. The aim of the study was to evaluate the effectiveness and safety of montelukast versus budesonide at different doses on bronchial reactivity in mild-asthmatic adult patients.
Patients and methods: A total of 40 patients were randomly assigned to a different treatment and divided in 2 treatment groups (A, B) as follows: A-10 mg of montelukast daily; B-400 mg of budesonide twice a day.
Results: We studied 40 subjects (21 males, 19 females) divided in two groups of 20 subjects each: group A with mean age 25.16 +/- 7.68 years, group B with mean age 26.18 +/- 6.15 years. After 16 weeks of treatment in the group A the PC20 (provocative concentration of methacholine which cause a fall of FEV1 > or = 20%) was 620.12 +/- 140.54 micrograms/mL significantly highly compared to basal value of 315.75 +/- 100.16 micrograms/mL (p < 0.02). In the group B the PC20 was 795.67 +/- 312.76 micrograms/mL significantly highly compared to basal value of 342.87 +/- 132.38 micrograms/mL (p < 0.001). We not found differences in FEV1, FVC e PEF before and after the treatment.
Conclusions: Montelukast may be considered a valid alternative in the treatment of mild-persistent asthma, both for the benefits on bronchial reactivity and for the great advantage of the once-daily dosage, which consistently improves the compliance with the chronic treatment of the disease.