help button home button
AJRCCM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by CHRISTIAN VIRCHOW, J.
Right arrow Articles by The Zafirlukast Study Group
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by CHRISTIAN VIRCHOW, J., Jr.
Right arrow Articles by The Zafirlukast Study Group,

Am. J. Respir. Crit. Care Med., Volume 162, Number 2, August 2000, 578-585

Zafirlukast Improves Asthma Control in Patients Receiving High-Dose Inhaled Corticosteroids

J. CHRISTIAN VIRCHOW Jr., ANTJE PRASSE, IAN NAYA, LINDA SUMMERTON, ALLAN HARRIS, and The Zafirlukast Study Group

Department of Pneumology, University Medical Clinic Freiburg, Germany; and AstraZeneca Pharmaceuticals, Macclesfield, United Kingdom

Not all asthma can be adequately controlled, despite the use of high-dose inhaled corticosteroids. Because cysteinyl-leukotrienes (Cys-LT) have been implicated in the pathogenesis of asthma, we hypothesized that the leukotriene receptor antagonist zafirlukast, in combination with high-doses of inhaled corticosteroids, might be efficacious in severe asthma. In a double-blind, parallel group study, 368 chronic adult asthmatic patients treated with inhaled corticosteroids (1,000 to 4,000 µg/d), who had a predefined level of asthma symptoms during the run in period of the study, were randomly assigned to receive additional treatment with a high dose of zafirlukast (80 mg twice daily) (n = 180) or placebo (n = 188) for 6 wk. Compared with placebo, zafirlukast produced a significant improvement over baseline in the primary study endpoint of mean morning peak expiratory flow rate (PEFR) (18.7 L/min versus 1.5 L/min, p < 0.001), as well as in evening PEFR (p < 0.01), FEV1 (p < 0.05), daytime symptom score (p < 0.001), and beta 2-agonist use (p < 0.001). Furthermore, zafirlukast significantly reduced the risk of an exacerbation of asthma (odds ratio [OR]: 0.61; 95% confidence interval [CI]: 0.38 to 0.99) and the risk of patients requiring a further increase in asthma controller therapy (OR: 0.4; 95% CI: 0.2 to 0.8). In conclusion, in patients taking high-dose inhaled corticosteroids, zafirlukast improves pulmonary function and asthma symptoms, and reduces the risk of an asthma exacerbation, suggesting that the contribution of leukotrienes to asthma symptoms and exacerbations is not adequately controlled by high-dose inhaled corticosteroids.




This article has been cited by other articles:


Home page
 Am. J. Respir. Crit. Care Med.Home page
H. K. Reddel, D. R. Taylor, E. D. Bateman, L.-P. Boulet, H. A. Boushey, W. W. Busse, T. B. Casale, P. Chanez, P. L. Enright, P. G. Gibson, et al.
An Official American Thoracic Society/European Respiratory Society Statement: Asthma Control and Exacerbations: Standardizing Endpoints for Clinical Asthma Trials and Clinical Practice
Am. J. Respir. Crit. Care Med., July 1, 2009; 180(1): 59 - 99.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
E. D. Bateman, S. S. Hurd, P. J. Barnes, J. Bousquet, J. M. Drazen, M. FitzGerald, P. Gibson, K. Ohta, P. O'Byrne, S. E. Pedersen, et al.
Global strategy for asthma management and prevention: GINA executive summary
Eur. Respir. J., January 1, 2008; 31(1): 143 - 178.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
H. Kanazawa, S. Nomura, and K. Asai
Roles of Angiopoietin-1 and Angiopoietin-2 on Airway Microvascular Permeability in Asthmatic Patients
Chest, April 1, 2007; 131(4): 1035 - 1041.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
M. Humbert
The Right Tools at the Right Time
Chest, July 1, 2006; 130(1_suppl): 29S - 40S.
[Abstract] [Full Text] [PDF]

Home page
 Chronic Respiratory DiseaseHome page
R Ratnawati and P S Thomas
Exhaled nitric oxide in paediatric asthma
Chronic Respiratory Disease, July 1, 2005; 2(3): 163 - 174.
[Abstract] [PDF]

Home page
 ChestHome page
W. Busse and M. Kraft
Cysteinyl Leukotrienes in Allergic Inflammation: Strategic Target for Therapy
Chest, April 1, 2005; 127(4): 1312 - 1326.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
A. R. L. Medford
Effects of Leukotriene Receptor Antagonists on Vascular Endothelial Growth Factor Levels in Asthma
Chest, April 1, 2005; 127(4): 1460 - 1461.
[Full Text] [PDF]

Home page
 ChestHome page
H. Kanazawa, T. Yoshikawa, K. Hirata, and J. Yoshikawa
Effects of Pranlukast Administration on Vascular Endothelial Growth Factor Levels in Asthmatic Patients
Chest, May 1, 2004; 125(5): 1700 - 1705.
[Abstract] [Full Text] [PDF]

Home page
 Proc Am Thorac SocHome page
P. M. O'Byrne
Pharmacologic Interventions to Reduce the Risk of Asthma Exacerbations
Proceedings of the ATS, April 1, 2004; 1(2): 105 - 108.
[Abstract] [Full Text] [PDF]

Home page
 Arch Intern MedHome page
L. Snyder, P. D. Blanc, P. P. Katz, E. H. Yelin, and M. D. Eisner
Leukotriene Modifier Use and Asthma Severity: How Is a New Medication Being Used by Adults With Asthma?
Arch Intern Med, March 22, 2004; 164(6): 617 - 622.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
G. P. Currie, D. K. C. Lee, K. Haggart, C. E. Bates, and B. J. Lipworth
Effects of Montelukast on Surrogate Inflammatory Markers in Corticosteroid-treated Patients with Asthma
Am. J. Respir. Crit. Care Med., May 1, 2003; 167(9): 1232 - 1238.
[Abstract] [Full Text] [PDF]

Home page
 Postgrad. Med. J.Home page
R H Green, C E Brightling, I D Pavord, and A J Wardlaw
Management of asthma in adults: current therapy and future directions
Postgrad. Med. J., May 1, 2003; 79(931): 259 - 267.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
H. S. Nelson and K. A. Rickard
Clarification of Salmeterol Studies
Chest, March 1, 2003; 123(3): 965 - 965.
[Full Text] [PDF]

Home page
 ThoraxHome page
N C Thomson and M Shepherd
Leukotriene receptor antagonists as add-on therapy for adults with asthma
Thorax, March 1, 2003; 58(3): 190 - 192.
[Abstract] [Full Text] [PDF]

Home page
 ThoraxHome page
M J Vaquerizo, P Casan, J Castillo, M Perpina, J Sanchis, V Sobradillo, A Valencia, H Verea, J L Viejo, C Villasante, et al.
Effect of montelukast added to inhaled budesonide on control of mild to moderate asthma
Thorax, March 1, 2003; 58(3): 204 - 210.
[Abstract] [Full Text] [PDF]

Home page
 ThoraxHome page
D B Price, D Hernandez, P Magyar, J Fiterman, K M Beeh, I G James, S Konstantopoulos, R Rojas, J A van Noord, M Pons, et al.
Randomised controlled trial of montelukast plus inhaled budesonide versus double dose inhaled budesonide in adult patients with asthma
Thorax, March 1, 2003; 58(3): 211 - 216.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
S. O'Sullivan, M. Akveld, C. M. Burke, and L. W. Poulter
Effect of the Addition of Montelukast to Inhaled Fluticasone Propionate on Airway Inflammation
Am. J. Respir. Crit. Care Med., March 1, 2003; 167(5): 745 - 750.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
S. Wenzel
Severe/Fatal Asthma
Chest, March 1, 2003; 123 (2009): 405S - 410S.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
G. P. Currie and B. J. Lipworth
Bronchoprotective Effects of Leukotriene Receptor Antagonists in Asthma* : A Meta-analysis
Chest, July 1, 2002; 122(1): 146 - 150.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
O. J. Dempsey, S. J. Fowler, A. Wilson, G. Kennedy, and B. J. Lipworth
Effects of Adding Either a Leukotriene Receptor Antagonist or Low-Dose Theophylline to a Low or Medium Dose of Inhaled Corticosteroid in Patients With Persistent Asthma*
Chest, July 1, 2002; 122(1): 151 - 159.
[Abstract] [Full Text] [PDF]

Home page
 BMJHome page
H. A M Kerstjens, H. J Groen, and W. van der Bij
Recent advances: Respiratory medicine
BMJ, December 8, 2001; 323(7325): 1349 - 1353.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
M. J. TOBIN
Asthma, Airway Biology, and Allergic Rhinitis in AJRCCM 2000
Am. J. Respir. Crit. Care Med., November 1, 2001; 164(9): 1559 - 1580.
[Full Text] [PDF]

Home page
 Journal of Pharmacy PracticeHome page
S. V. Bourdet and D. Williams
Management Considerations for Chronic Asthma
Journal of Pharmacy Practice, April 1, 2001; 14(2): 108 - 125.
[Abstract] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Proc. Am. Thorac. Soc. Am. J. Respir. Cell Mol. Biol.
Copyright © 2000 American Thoracic Society