BMJ  2003;327 (18 October), doi:10.1136/bmj.327.7420.0

Montelukast plus fluticasone is equivalent to salmeterol and fluticasone

Adding montelukast to the treatment regimen of asthma patients whose symptoms remain uncontrolled by fluticasone provides equivalent control to adding salmeterol. In a double blind randomised controlled trial, Bjermer and colleagues (p 891) randomised 1500 patients with uncontrolled asthma symptoms taking fluticasone to receive either montelukast or salmeterol as well. At one year, 20% of patients in each group had had an exacerbation of asthma. The authors say that the agonist salmeterol and the anti-leukotriene montelukast are known to reduce the risk of exacerbation when combined with a corticosteroid, but the two had not been compared directly in a long term study with exacerbation of asthma as the primary end point.

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Relevant Article

Montelukast and fluticasone compared with salmeterol and fluticasone in protecting against asthma exacerbation in adults: one year, double blind, randomised, comparative trial

Leif Bjermer, Hans Bisgaard, Jean Bousquet, Leonardo M Fabbri, Andrew P Greening, Tari Haahtela, Stephen T Holgate, Cesar Picado, Joris Menten, S Balachandra Dass, Jonathan A Leff, and Peter G Polos
BMJ 2003 327: 891. [Abstract] [Full Text] [PDF]