Comparative efficacy of leukotriene modifier and inhaled corticosteroids in the complex treatment of steroid-naive patients with bronchial asthma combined with chronic obstructive pulmonary disease with neutrophilic type of inflammation

The aim: to compare the efficacy and tolerability of the leukotriene modifier and inhaled corticosteroids in combination with long-acting β2-agonist formoterol in steroid-naive patients with asthma combined with COPD with neutrophilic inflammation. Materials and methods. After obtaining the writt...

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Main Authors: Yu. I. Feshchenko, L. O. Yashyna, V. I. Ihnatieva, M. O. Polianska, S. H. Opimakh, I. V. Zvol, S. M. Moskalenko, H. L. Humeniuk, N. A. Vlasova, L. A. Halai
Format: Article
Language:English
Published: Zaporozhye State Medical University 2021-07-01
Series:Zaporožskij Medicinskij Žurnal
Subjects:
Online Access:http://zmj.zsmu.edu.ua/article/view/229508/236535
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author Yu. I. Feshchenko
L. O. Yashyna
V. I. Ihnatieva
M. O. Polianska
S. H. Opimakh
I. V. Zvol
S. M. Moskalenko
H. L. Humeniuk
N. A. Vlasova
L. A. Halai
author_facet Yu. I. Feshchenko
L. O. Yashyna
V. I. Ihnatieva
M. O. Polianska
S. H. Opimakh
I. V. Zvol
S. M. Moskalenko
H. L. Humeniuk
N. A. Vlasova
L. A. Halai
author_sort Yu. I. Feshchenko
collection DOAJ
description The aim: to compare the efficacy and tolerability of the leukotriene modifier and inhaled corticosteroids in combination with long-acting β2-agonist formoterol in steroid-naive patients with asthma combined with COPD with neutrophilic inflammation. Materials and methods. After obtaining the written consent, 30 patients with asthma combined with COPD and a number of blood neutrophils >4000/μl were randomized (1:1): group I – received a fixed combination of budesonide/formoterol 160/4.5 μg/1 inhalation twice daily as a basic therapy; group II – montelukast 1 tab. (10 mg) once daily and inhalation of formoterol 12 mcg/dose twice daily. The duration of therapy was 12 weeks. General clinical methods, asthma control questionnaires, COPD questionnaire, physical tolerance evaluation (6-minute walk test), pulmonary function tests, quality of life assessment were performed to all the patients before and after the treatment course studied. Results. The combination of budesonide/formoterol improved clinical symptoms – significantly (P < 0.05) increased the total ACT score, decreased the average ACQ score, shortness of breath (mMRC scale), COPD symptoms. PFT indices were improved significantly (P < 0.05), bronchoobstruction at the level of large, medium and small bronchi was significantly reduced. Physical tolerance was significantly improved. There were no statistically significant dynamics of the studied indices in patient group II. The patients of both groups showed a tendency to improve their quality of life. In patients of I group, there was a significant decrease in activity limitations and the total SGRQ score. Conclusions. The combination of inhaled corticosteroid/formoterol has proven to be more effective than the leukotriene modifier or formoterol in steroid-naive patients with asthma combined with COPD and neutrophilic inflammation.
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spelling doaj.art-8a015b81086441948f2e169687b336d32022-12-21T20:13:21ZengZaporozhye State Medical UniversityZaporožskij Medicinskij Žurnal2306-41452310-12102021-07-0123451652310.14739/2310-1210.2021.4.229508Comparative efficacy of leukotriene modifier and inhaled corticosteroids in the complex treatment of steroid-naive patients with bronchial asthma combined with chronic obstructive pulmonary disease with neutrophilic type of inflammationYu. I. Feshchenko0https://orcid.org/0000-0002-8650-0289L. O. Yashyna1https://orcid.org/0000-0002-4264-1207V. I. Ihnatieva2https://orcid.org/0000-0003-0604-4349M. O. Polianska3https://orcid.org/0000-0003-0305-7988S. H. Opimakh4https://orcid.org/0000-0002-4631-2048I. V. Zvol5https://orcid.org/0000-0001-8533-2618S. M. Moskalenko6https://orcid.org/0000-0002-5017-0230H. L. Humeniuk7https://orcid.org/0000-0001-8160-7856N. A. Vlasova8https://orcid.org/0000-0002-7590-4704L. A. Halai9SI “National Institute of Phthisiology and Pulmonology named after F. H. Yanovskyi NAMS of Ukraine”, KyivSI “National Institute of Phthisiology and Pulmonology named after F. H. Yanovskyi NAMS of Ukraine”, KyivSI “National Institute of Phthisiology and Pulmonology named after F. H. Yanovskyi NAMS of Ukraine”, KyivSI “National Institute of Phthisiology and Pulmonology named after F. H. Yanovskyi NAMS of Ukraine”, KyivSI “National Institute of Phthisiology and Pulmonology named after F. H. Yanovskyi NAMS of Ukraine”, KyivSI “National Institute of Phthisiology and Pulmonology named after F. H. Yanovskyi NAMS of Ukraine”, KyivSI “National Institute of Phthisiology and Pulmonology named after F. H. Yanovskyi NAMS of Ukraine”, KyivSI “National Institute of Phthisiology and Pulmonology named after F. H. Yanovskyi NAMS of Ukraine”, KyivSI “National Institute of Phthisiology and Pulmonology named after F. H. Yanovskyi NAMS of Ukraine”, KyivSI “National Institute of Phthisiology and Pulmonology named after F. H. Yanovskyi NAMS of Ukraine”, KyivThe aim: to compare the efficacy and tolerability of the leukotriene modifier and inhaled corticosteroids in combination with long-acting β2-agonist formoterol in steroid-naive patients with asthma combined with COPD with neutrophilic inflammation. Materials and methods. After obtaining the written consent, 30 patients with asthma combined with COPD and a number of blood neutrophils >4000/μl were randomized (1:1): group I – received a fixed combination of budesonide/formoterol 160/4.5 μg/1 inhalation twice daily as a basic therapy; group II – montelukast 1 tab. (10 mg) once daily and inhalation of formoterol 12 mcg/dose twice daily. The duration of therapy was 12 weeks. General clinical methods, asthma control questionnaires, COPD questionnaire, physical tolerance evaluation (6-minute walk test), pulmonary function tests, quality of life assessment were performed to all the patients before and after the treatment course studied. Results. The combination of budesonide/formoterol improved clinical symptoms – significantly (P < 0.05) increased the total ACT score, decreased the average ACQ score, shortness of breath (mMRC scale), COPD symptoms. PFT indices were improved significantly (P < 0.05), bronchoobstruction at the level of large, medium and small bronchi was significantly reduced. Physical tolerance was significantly improved. There were no statistically significant dynamics of the studied indices in patient group II. The patients of both groups showed a tendency to improve their quality of life. In patients of I group, there was a significant decrease in activity limitations and the total SGRQ score. Conclusions. The combination of inhaled corticosteroid/formoterol has proven to be more effective than the leukotriene modifier or formoterol in steroid-naive patients with asthma combined with COPD and neutrophilic inflammation.http://zmj.zsmu.edu.ua/article/view/229508/236535bronchial asthmachronic obstructive lung diseasetreatment
spellingShingle Yu. I. Feshchenko
L. O. Yashyna
V. I. Ihnatieva
M. O. Polianska
S. H. Opimakh
I. V. Zvol
S. M. Moskalenko
H. L. Humeniuk
N. A. Vlasova
L. A. Halai
Comparative efficacy of leukotriene modifier and inhaled corticosteroids in the complex treatment of steroid-naive patients with bronchial asthma combined with chronic obstructive pulmonary disease with neutrophilic type of inflammation
Zaporožskij Medicinskij Žurnal
bronchial asthma
chronic obstructive lung disease
treatment
title Comparative efficacy of leukotriene modifier and inhaled corticosteroids in the complex treatment of steroid-naive patients with bronchial asthma combined with chronic obstructive pulmonary disease with neutrophilic type of inflammation
title_full Comparative efficacy of leukotriene modifier and inhaled corticosteroids in the complex treatment of steroid-naive patients with bronchial asthma combined with chronic obstructive pulmonary disease with neutrophilic type of inflammation
title_fullStr Comparative efficacy of leukotriene modifier and inhaled corticosteroids in the complex treatment of steroid-naive patients with bronchial asthma combined with chronic obstructive pulmonary disease with neutrophilic type of inflammation
title_full_unstemmed Comparative efficacy of leukotriene modifier and inhaled corticosteroids in the complex treatment of steroid-naive patients with bronchial asthma combined with chronic obstructive pulmonary disease with neutrophilic type of inflammation
title_short Comparative efficacy of leukotriene modifier and inhaled corticosteroids in the complex treatment of steroid-naive patients with bronchial asthma combined with chronic obstructive pulmonary disease with neutrophilic type of inflammation
title_sort comparative efficacy of leukotriene modifier and inhaled corticosteroids in the complex treatment of steroid naive patients with bronchial asthma combined with chronic obstructive pulmonary disease with neutrophilic type of inflammation
topic bronchial asthma
chronic obstructive lung disease
treatment
url http://zmj.zsmu.edu.ua/article/view/229508/236535
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