Asthma is a chronic disease affecting millions of people worldwide. Traditionally, inhaled steroids have been the most effective treatment option for asthma. In addition to their anti-inflammatory effects, these steroids also have a cough suppressant action which is particularly useful in cough variant asthma (CVA). However, due to the harmful side effects associated with chronic steroid use, new drugs are being investigated for treating CVA.
Asthma is a chronic disease of the lungs affecting both children and adults. It is characterized by the narrowing of the small airways of the lung resulting in breathing difficulty and wheezing.
Cough variant asthma is a type of asthma that primarily causes coughing, with little or no wheezing. It can be a challenging condition to treat, as the underlying inflammation that causes the cough may not respond well to standard asthma medications. Inhaled corticosteroids have been the initial drug of choice in CVA, however, their side effects have led scientists to explore other drugs that might be useful in people suffering from CVA. Some of these include montelukast, budesonide, and formoterol.
Montelukast is a medication that works by blocking the action of leukotrienes, which are chemicals that play a role in inflammation. Budesonide/formoterol is a combination inhaler that contains two medications: budesonide, which is a steroid that reduces inflammation, and formoterol, which is a bronchodilator that helps to open up the airways.
Clinical TrialA clinical trial was conducted to evaluate the effects of three different treatments for CVA: montelukast alone, budesonide/formoterol alone, and a combination of both.
The trial included 99 participants with CVA who were randomly assigned to one of the three treatment groups. These patients were divided in a 1:1:1 ratio to receive montelukast (M group: 10 mg, once daily), budesonide/formoterol (BF group: 160/4.5 μg, one puff, twice daily), or montelukast plus budesonide/formoterol (MBF group) for 8 weeks.
At the end of the treatment, their cough and asthma symptoms were recorded with the help of a cough visual analog scale (VAS) score, daytime cough symptom score (CSS), and night-time CSS.
ResultsThe results of the clinical trial showed that all three treatments were effective in reducing coughing and improving lung function. The average cough VAS score (median from 6.0 to 2.0 in the M group, 5.0 to 1.0 in the BF group, and 6.0 to 1.0 in the MBF group), daytime CSS and night-time CSS decreased significantly in all three groups after treatment for 8 weeks.
Additionally, the researchers also noted that there were no significant differences in the effectiveness of the three groups for the treatment of CVA.
ConclusionThis clinical trial provides important insights into the treatment of CVA, showing that in addition to the traditional inhaled steroids treatment, alternative drug regimens such as montelukast alone, budesonide/formoterol alone, or a combination of both are equally effective for the management of CVA.
Respiratory Research, Oct-10-22