Protection of leukotriene receptor antagonist against aspirin-induced bronchospasm in asthmatics
- Authors
- Park, Jong Sook; Jang, An Soo; Park, Sung Woo; Lee, Young Mok; Uh, Soo Taek; Kim, Yong Hoon; Cha, Ji Yean; Park, Se Min; Park, Choon-Sik
- Issue Date
- Jan-2010
- Publisher
- 대한천식알레르기학회
- Keywords
- Asthma; leukotriene antagonists; aspirin; eosinophils
- Citation
- Allergy, Asthma & Immunology Research, v.2, no.1, pp 48 - 54
- Pages
- 7
- Journal Title
- Allergy, Asthma & Immunology Research
- Volume
- 2
- Number
- 1
- Start Page
- 48
- End Page
- 54
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/18111
- DOI
- 10.4168/aair.2010.2.1.48
- ISSN
- 2092-7355
2092-7363
- Abstract
- Purpose: Leukotriene receptor antagonists (LTRAs) are used to treat aspirin-intolerant asthma (AIA); however, the protective effects of long-term LTRA administration against aspirin-induced bronchospasm have not been evaluated. Objectives: We investigated the efficacy of a 12-week treatment with a LIRA in protecting against aspirin-induced asthma in AIA patients. Methods: Fifty-two adult patients with AIA underwent an aspirin challenge test just before administration of montelukast (10 mg/day) and just after 12 weeks of treatment. The protective effect was assessed as the disappearance of aspirin-induced bronchospasm after 12 weeks of treatment. The results were compared according to the patients' clinical and physiological parameters. Results: The decline in FEV1 following aspirin challenge was significantly reduced from 28.6 +/- 1.9% to 10.2 +/- 1.7% (P=0.0001) after 12 weeks of montelukast treatment. However, 14 subjects (30%) still showed a positive response (>15% decline in FEV1) to aspirin challenge. Grouping the subjects into good and poor responders according to post-treatment responses revealed that the pretreatment aspirin-induced FEV1 decline was significantly greater in the poor responders and that the triggering dose of aspirin and the induction time for a positive response were lower and shorter, respectively, in the poor responders. Histories of aspirin hypersensitivity and sinusitis were more prevalent among the poor responders than among the good responders. Conclusions: Twelve weeks of treatment with montelukast protected against aspirin-induced bronchospasm in 70% of the AIA cases. A poor response was associated with more severe aspirin-induced bronchospasms before treatment and a history of aspirin hypersensitivity or sinusitis. Clinical implications: A severe response to aspirin challenge may be a predictor of poor responsiveness to leukotriene antagonist treatment.
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Collections - College of Medicine > Department of Internal Medicine > 1. Journal Articles
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