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BMJ 2003; 326 doi: (Published 08 March 2003) Cite this as: BMJ 2003;326:521
  1. Harvey Marcovitch (
  1. BMJ syndication editor

    Montelukast is a useful adjunct in persistent asthma

    Two large randomised trials show the value of the leukotriene receptor antagonist montelukast in adults with asthma already treated with inhaled steroids. The Spanish CASIOPEA study group randomised 639 patients receiving budesonide 400–1600 μg daily by Turbuhaler to receive montelukast 10 mg daily or placebo. Patients were followed up for four months: the treated group had 56% more days free of asthma and 35% fewer mild exacerbations than those taking placebo, and they were less likely to wake at night, had a greater improvement in morning peak flow rate, and used less β agonist. The international COMPACT trial looked at adults whose asthma was inadequately controlled with budesonide 800 μg. They were randomised to receive 10 mg of montelukast in addition to their existing treatment or to double their dose of budesonide. After 12 weeks both groups had improved, with fewer symptoms, better quality of life, and less use of β agonists. The montelukast group had …

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