Some studies have proposed a link between bronchial smooth muscle tone, reactivity, and inflammation,28 and muscle cells by themselves may contribute to inflammation by mechanisms that are suppressed by salmeterol.29 It is not certain if smooth muscle relaxation by itself could serve as a protective factor against asthma exacerbations. Asthma Section, Respiratory Society, Chinese Medical Association. HHS Vulnerability Disclosure, Help We used Poisson regression with robust variance estimates for a secondary analysis of the number of asthma exacerbations. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) will be used to assess the quality of evidence. HB has received a fee from Merck for speaking, organising education, and consulting, and has received funds for research. It is used to help prevent the symptoms of asthma. Montelukast added to inhaled beclomethasone in treatment of asthma. Studies shows that montelukast sodium combined with fluticasone has a better clinical effect in adult BA. And the quality of evidence will be rated as high, moderate, low, and very low. The course of disease is also different, and may have a certain impact on the results. Epub 2018 Oct 24. Analysisby using the Kaplan-Meier method, which accounts for censored observations (such as dropouts)of the estimated cumulative percentage of patients with an asthma exacerbation during the treatment period supported the primary analysis: montelukast and fluticasone 21.8% and salmeterol and fluticasone 20.6%, with the estimated risk ratio of 1.06 in favour of salmeterol and fluticasone (0.86 and 1.30). [1]. Cheng GS, Storer B, Chien JW, Jagasia M, Hubbard JJ, Burns L, Ho VT, Pidala J, Palmer J, Johnston L, Mayer S, Crothers K, Pusic I, Lee SJ, Williams KM. Background: National Institutes of Health, National Heart, Lung and Blood Institute. Bronchial asthma (BA) is a chronic airway inflammatory disease with reversible airflow limitation as the main clinical manifestations, such as wheezing, cough, shortness of breath, chest tightness, etc, mediated by a variety of inflammatory cells, which can be recurrent. modify the keyword list to augment your search. Eur Respir J. [12] Typical asthma attack symptoms are easy to identify, but the etiology of asthma is complex, its attack and the body's reactivity, that is, genetic factors and atopic quality of individual differences, allergens, and stimuli of different quality and quantity, can lead to asthma attack symptoms of ever-changing. Save 2.20. Both drugs significantly decreased the frequency of nocturnal awakening, a variable exacerbation of the underlying asthma condition that is associated with an increased influx of inflammatory cells, particularly lymphocytes, macrophages, and eosinophils, into the small and peripheral airways.24 It is therefore reasonable to speculate that the protective effect seen with montelukast is due to its anti-inflammatory action in the small airways. Alkhunaizi M, Patel B, Bueno L, Bhan N, Ahmed T, Arain MH, Saliba R, Rondon G, Dickey BF, Bashoura L, Ost DE, Li L, Wang S, Shpall E, Champlin RE, Mehta R, Popat UR, Hosing C, Alousi AM, Sheshadri A. Data is temporarily unavailable. This sample size calculation used data from previous work7,8 and was based on an assumed percentage of patients with asthma exacerbations equal to 23% on the combination of montelukast and fluticasone and equal to 24% on the combination of salmeterol and fluticasone. We tested this in a phase II, single-arm, open-label, multicenter study (NCT01307462). Writing original draft: Huiling luo and Hongmei Han. Pauwels RA, Lfdahl C-G, Postma DS, Tattersfield AE, Byrne P, Barnes PJ, et al. an improve symptoms, but cannot be cured; glucocorticoid is the most important first-line medication. Enter other medications to view a detailed report. Scadding G, Price D, El-Shanawany T, Ahmed S, Ray J, Sargur R, Kumar N. BMJ Open. Azithromycin; Bronchiolitis obliterans syndrome; Fluticasone; Hematopoietic cell transplantation; Leukotrienes; Lung chronic graft-versus-host disease; Montelukast. HHS Vulnerability Disclosure, Help Tumor necrosis factor-, interleukin-8 and eosinophil cationic protein as serum markers of glucocorticoid efficacy in the treatment of, [21]. However, there are differences in the research scheme and curative effect of each clinical trial, which leads to the uneven results, which to some extent affects the promotion of the therapy. If there are missing data in the article, contact the author via email for additional information. Before 2016 Apr;22 (4):710-716. doi: 10.1016/j.bbmt.2015.10.009. We hypothesized that inhaled fluticasone, azithromycin, and montelukast (FAM) with a brief steroid pulse could avert progression of new-onset BOS. The addition of montelukast to an intranasal corticosteroid for the treatment of PAR with residual symptoms is no more effective than is placebo. doi: 10.1016/j.jtct.2022.12.001. Nationality, race, gender, and course of illness are not limited. 48% of reviewers reported a positive effect, while 31% reported a negative effect. and transmitted securely. Trial registration: Patel P, Philip G, Yang W, Call R, Horak F, LaForce C, Gilles L, Garrett GC, Dass SB, Knorr BA, Reiss TF. Some error has occurred while processing your request. The study was conducted between January 2000 and December 2001. . Before 2017 May 9;10:153-161. doi: 10.2147/JAA.S128431. Epub 2016 Aug 26. The risk ratio (montelukast-fluticasone/salmeterol-fluticasone) was 1.05 (0.86 to 1.29). Clinical response to belumosudil in bronchiolitis obliterans syndrome: a combined analysis from 2 prospective trials. 2009 Aug;31(8):1664-87. doi: 10.1016/j.clinthera.2009.08.015. Evaluation of salmeterol or montelukast as second-line therapy for asthma not controlled with inhaled corticosteroids. Wang YC. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. J Asthma Allergy. The primary endpoint was treatment failure, defined as 10% or greater forced expiratory volume in 1 second decline at 3 months. Some mixtures of medications can lead to serious and even fatal consequences. Distal lung dysfunction at night in nocturnal asthma. a) 83% of patients had study-defined documented success on 3 month PFTs, 3% percent had documented failure at 3 months (10% or more absolute decline in percent predicted FEV1) and 5 (14%) were missing 3 month PFTs. In clinical trials, however, only 50% of patients obtain excellent symptom control. FOIA Asthma. Adult patients with definite diagnosis of BA,[11] excluding pregnant or lactating women, patients complicated with malignant tumor, patients complicated with severe heart, brain, kidney, lung, liver diseases, and other diseases. The https:// ensures that you are connecting to the In the induced sputum subgroup study, the numbers of eosinophils in sputum decreased significantly over the 48 week period in the montelukast-fluticasone group (mean eosinophil score from 1.52 to 0.91 (on a scale of 0-3), P < 0.005), whereas they did not change significantly in the salmeterol-fluticasone group (mean eosinophil score from 1.50 to 1.79). These improvements in FEV 1 at end point represented a 23% increase from baseline with FSC compared with an 11% increase with montelukast (p 0.001). Greater differential response to fluticasone over montelukast was associated with higher bronchodilator use, bronchodilator response, exhaled nitric oxide levels, and eosinophil cationic protein levels and lower methacholine PC 20 and pulmonary function values. [14] Therefore, the treatment of adult BA has received more and more attention. Villaran C, O'Neill SJ, Helbling A, van Noord JA, Lee TH, Chuchalin AG, et al. There are 100 drugs known to interact with montelukast, along with 4 disease interactions. The addition of a leukotriene receptor antagonist to an inhaled corticosteroid therefore represents a reasonable and alternative therapeutic option for the treatment of asthma patients whose symptoms remain uncontrolled on inhaled corticosteroids. Expert Working Group. 2023 Apr;117(4):578-589. doi: 10.1007/s12185-022-03517-3. China Hematology Association, Chinese Medical Doctor Association;; Chinese Society of Hematology, Chinese Medical Association. The site is secure. Vanaudenaerde BM, Meyts I, Vos R, Geudens N, De Wever W, Verbeken EK, Van Raemdonck DE, Dupont LJ, Verleden GM. Careers, Unable to load your collection due to an error. However, this systematic review has some limitations. Treatment of asthma with drugs modifying the leukotriene pathway. One hundred two patients with a history . Data collection: Huiling luo and Hongmei Han. Children and adolescents are more likely to suffer from,[3] adults are also vulnerable, and it repeatedly attacks, affecting work and life, causing great distress to adults. Is It OK to Take All Your Medications at Once? Prevalence, risk factors, and management of asthma in China: a national cross-sectional study. Get new journal Tables of Contents sent right to your email inbox, http://creativecommons.org/licenses/by/4.0, Efficacy and safety of montelukast sodium combined with fluticasone in the treatment of adult bronchial asthma: A protocol for systematic review and meta-analysis, Articles in Google Scholar by Huiling Luo, MB, Other articles in this journal by Huiling Luo, MB, Privacy Policy (Updated December 15, 2022). 2007;67(6):887-901. doi: 10.2165/00003495-200767060-00005. At present, there are many randomized controlled studies,[710] which show that montelukast sodium combined with fluticasone in the treatment of adult BA can effectively improve the clinical efficacy, control the symptoms of clinical acute attack, improve the lung function of patients, and have high clinical application value. Measurement of patient-oriented assessments such as quality of life provides information on the impact of disease in patients with asthma. Figure 1. a and b: FAM stabilizes FEV1 in the majority of patients at 3, Figure 2. Wolters Kluwer Health We thank Pam S Dellea, the study monitor, and Barbara Knorr, Theodore Reiss, Jonathan Edelman, and Nancy Santanello for input into the study design and for discussions. Bookshelf Objectives To assess the effect of montelukast versus salmeterol added to inhaled fluticasone propionate on asthma exacerbation in patients whose symptoms are inadequately controlled with fluticasone alone. Two short term (12 week) studies have compared asthma exacerbation rates in patients treated with either montelukast or salmeterol added to inhaled corticosteroids. Jarvis B, Markham A. Montelukast: a review of its therapeutic potential in persistent asthma. Patients in both treatment groups showed significant increases (P 0.001) from baseline in FEV1 before using a agonist throughout the 48 week treatment period (least squares mean (SE) change from baseline of 0.11 (0.02) (montelukast-fluticasone) versus 0.19 (0.02) (salmeterol-fluticasone), P 0.001 for difference between groups). on functional and inflammatory parameters in steroid . When used regularly (every day), inhaled fluticasone decreases the number and severity of asthma attacks. 19.79. Montelukast (Singulair) Zafirlukast (Accolate) Zileuton (Zyflo) In rare cases, montelukast is linked to psychological reactions, such as agitation, aggression, hallucinations, depression and suicidal thinking. Our results compare favourably with those of a previously reported one year study, where high dose budesonide and formoterol provided protection against severe asthma exacerbations (defined as requiring treatment with oral glucocorticoids or causing a decrease in morning peak expiratory flow of more than 30% below the baseline value on two consecutive days) in about 81% of patients, with an estimated yearly asthma exacerbation rate of 0.34 per patient.7. STH has received fees from Merck for consulting. Approved as a pharmacy medicine, Sanofi will launch Cialis Together in the second half of the year. Steroid dose was reduced by 50% or more at 3 months in 48% of patients who could be evaluated (n = 27). 2019. Association between early corticosteroid administration and long-term survival in non-infectious pulmonary complications after allogeneic hematopoietic stem cell transplantation. Montelukast/Salmeterol Exercise Study Group. At 3 months, 6% (2 of 36, 95% confidence interval, 1% to 19%) had treatment failure (versus 40% in historical controls, P < .001). Unable to load your collection due to an error, Unable to load your delegates due to an error. Clinical adverse experiences were reported by 530 (71.0%) and 538 (72.4%) patients in the montelukast-fluticasone and salmeterol-fluticasone groups, respectively. Nasser M, Fahmey S, Geogry D, Taha GE. 2017 Apr 24;7(4):e014777. Shen C, Chen F, Wang H, Zhang X, Li G, Wen Z. Braz J Otorhinolaryngol. Conclusions Response to fluticasone and montelukast vary considerably. The montelukast-fluticasone group showed a significantly smaller decrease from baseline in percentage reversibility in FEV1 compared with the salmeterol-fluticasone group (least squares mean (SE) change from baseline of -7.54 (0.40) versus -11.26 (0.40), P 0.001 for difference between groups). The production of cysteinyl leukotrienes has been shown to be unaffected by steroids,20,21 and treatment with leukotriene receptor antagonists is known to suppress inflammation in asthma as well as prevent bronchoconstriction. The results of this study imply that the addition of montelukast in patients whose symptoms remain uncontrolled with inhaled fluticasone could be as effective as adding salmeterol in protecting against asthma exacerbations. Nucala, prednisone, albuterol, fluticasone nasal, loratadine, cetirizine, Zyrtec, promethazine, Symbicort, Singulair. Bone Marrow Transplant. Writing original draft: Huiling luo, Hongmei Han. FAM was well tolerated. This study assessed the efficacy and safety of montelukast sodium combined with fluticasone in the treatment of adult BA through total effective rate, pulmonary function (FEV1, FVC, PEF, FEV1/FVC), and adverse reactions. Woolcock A, Lundback B, Ringdal N, Jacques L. Comparison of addition of salmeterol to inhaled steroids with doubling of the dose of inhaled steroids. b) Proportion of patients (n=30 evaluable at 3 months) with greater or equal to 5% improvement, greater than or equal to 5% decline (and including those who were not able to be evaluated as these failures), or less than 5% change (stability). The mechanism behind the protective effect of long acting agonists on asthma exacerbations is not clear. Fluticasone has an average rating of 6.1 out of 10 from a total of 66 ratings on Drugs.com. This work also provides useful evidence for determining the efficacy and safety of montelukast sodium combined with fluticasone in the treatment of adult BA patients, which is beneficial for both clinical practice and health-related decision makers. If these 5 indexes are consistent, the quality of the literature is high, otherwise the bias may be generated. Funnel plots were used to assess publication bias if no fewer than 10 studies were included in an outcome measure. This is the first study to compare the efficacy and safety of the combination product, fluticasone propionate (100 g) and salmeterol (50 g), with that of oral montelukast (10 mg) as initial maintenance therapy in patients with persistent asthma who were uncontrolled on short-acting 2-agonists alone. Guidelines for the prevention and treatment of, [20]. Of the patients in the montelukast-fluticasone group (n = 747), the proportion (number) with zero, one, two, three, or four to six asthma exacerbations was 79.9% (597), 13.7% (102), 3.5% (26), 2.0% (15), and 0.9% (7), respectively. If there is significant clinical heterogeneity between the 2 groups, and grouping analysis is not available, descriptive analysis will be used. Epub 2016 Jan 21. In order to test the stability of meta-analysis results of indicators, a one-by-one elimination method will be adopted for sensitivity analysis. See your health care provider right away if you have any unusual reaction. In addition, it has been registered on open science framework (OSF) on October 25, 2020. Would you like email updates of new search results? This is not a complete list of side effects and others may occur. Sick people, especially adults, may gradually lose their ability to work, which places a huge economic burden on the health care system and society. Montelukast is generally well-tolerated. Trajectory of FEV1 over time after FAM exposure, Individual percent predicted FEV1 values, MeSH Fish Oil (omega-3 polyunsaturated fatty acids), Probiotic Formula (bifidobacterium infantis / lactobacillus acidophilus), Email this report to a friend, doctor, or patient. Bethesda, MD 20894, Web Policies Use RevMan5.3 software provided by Cochrane collaboration for statistical analysis. Montelukast is in the drug class leukotriene modifiers . [17]. The main drugs used in BA are glucocorticoid,2 receptor agonist, anticholinergic agent, theophylline, leukotriene receptor antagonist, mast cell membrane stabilizer and others. Ren J, Sun Y, Li G, et al. government site. Safety of a novel intranasal formulation of azelastine hydrochloride and fluticasone propionate in children: A randomized clinical trial. Whether leukotriene receptor antagonists exhibit adequate anti-inflammatory effects in the treatment of asthma is still a controversial issue. This systematic review also does not involve endangering participant rights. Inhaled glucocorticoid can enhance local anti-inflammatory effect of airway and reduce systemic effect, so it is the most effective drug for asthma. Accessibility Busse, W. W. Inflammation in asthma: the cornerstone of the disease and target of therapy. According to previous studies, the occurrence of the disease is not only related to a variety of cell-mediated inflammatory reactions, but also involved in neuroregulation and immune response. 2020 Jan-Feb;86(1):63-73. doi: 10.1016/j.bjorl.2018.09.007. Juniper, EF, Guyatt, GH, Willan, A, Griffith LE. Although our data do not address such mechanistic processes, our results show that montelukast provides protection against asthma exacerbations equivalent to that provided by salmeterol. View interaction reports for montelukast and the medicines listed below. Patients' demographics and baseline characteristics. Salmeterol powder provides significantly better benefit than montelukast in asthmatic patients receiving concomitant inhaled corticosteroid therapy. Images. Please try after some time. Barnes PJ. Thirty-six patients were enrolled within 6 months of BOS diagnosis. We hypothesized that inhaled fluticasone, azithromycin, and montelukast (FAM) with a brief steroid pulse could avert progression of new-onset BOS. The authors declare that they have no conflicts of interest. JM, SBD, JAL, and PGP are employees of Merck and have stock options or own shares in the company. They therefore imply that the use of leukotriene receptor antagonists such as montelukast is an additional therapeutic option for these patients. This study will provide reliable evidence-based evidence for the clinical application of montelukast sodium combined with fluticasone in the treatment of adult BA. The .gov means its official. Levocetirizine for the treatment of allergic rhinitis and chronic idiopathic urticaria in adults and children. El-Radhi AS, Hogg CL, Bungre JK, Bush A, Corrigan CJ. Design and setting A 52 week, two period, double blind, multicentre trial during which patients whose symptoms remained uncontrolled by inhaled corticosteroids were randomised to add montelukast or salmeterol. We chose 1.33 as our inferiority limit to preserve at least half of the active treatment effect and to represent a difference of 0.29 in the log scale. Lung Function Trajectory in Bronchiolitis Obliterans Syndrome after Allogeneic Hematopoietic Cell Transplant. Published by Elsevier Inc. All rights reserved. Total effective rate = (cure number + effective number)/ total number 100%. Values are numbers (percentages) of patients. At present, the commonly used clinical drugs are budesonide, momethasone, fluticasone-formoterol inhalants, and so on. Effect of. Published by Wolters Kluwer Health, Inc. (1) Primary outcome: the overall effective rate. eCollection 2018. Clinical outcome of adding long-acting beta-agonists to inhaled corticosteroids. Of the patients in the montelukast-fluticasone group 20.1% (150/747) had at least one asthma exacerbation, compared with 19.1% (142/743) for the salmeterol-fluticasone group (table 3). If we cannot analyze the source of heterogeneity, random effect model can be used to analyze. Drazen JM, Israel E, O'Byrne PM. This work is supported by the Project of Lanzhou science and technology development guiding plan project in 2018 (No.2018-ZD-34). Montelukast and fluticasone significantly (P = 0.011) reduced peripheral blood eosinophil counts compared with salmeterol and fluticasone. Randomized, double-blind, placebo-controlled study of montelukast for treating perennial allergic rhinitis. Contributors: JAL, LB, HB, JB, LMF, APG, TH, STH, CP, and JM designed the study; JAL, LB, HB, JB, LMF, APG, TH, STH, CP, and P S Dellea conducted the study. We will collect all available randomized controlled trials (RCTs) on montelukast sodium combined with fluticasone in the treatment of adult BA, regardless of blinding, publication status, and region; however, the language will be limited to only Chinese and English. Mandlik DS, Mandlik SK. Bronchial asthma (BA) is a chronic inflammatory disease of the airway mediated by many inflammatory cells, such as eosinophils, mast cells, T lymphocytes,[1,2] which often leads to airway hyperresponsiveness, extensive and variable reversible airflow limitation, and causes recurrent symptoms such as wheezing, expiratory dyspnea, chest tightness, or cough. Children with mild obstructive sleep apnea treated with montelukast and fluticasone experience significant improvements in quality of life. Read the full text carefully for studies that may meet the inclusion criteria and determine the final RCT. (Registration number: DOI 10.17605/OSF.IO/CKQFM). Biol Blood Marrow Transplant. The absence of tolerance with montelukast in long term treatment may also be an advantage.12,30. National Library of Medicine Given the importance of chronic inflammation in the pathogenesis of asthma,18 international guidelines have assigned increasing importance to the use of anti-inflammatory agents such as inhaled corticosteroids.1 Nevertheless, the addition of a second agent has been shown convincingly to reduce asthma exacerbations more than with inhaled corticosteroids alone.7,19 Thus international guidelines now advocate treatment with long acting agonists added to inhaled corticosteroids. This protocol of systematic review and meta-analysis has been drafted under the guidance of the preferred reporting items for systematic reviews and meta-analyses protocols (PRISMA-P). Effect of oral glucocorticoid treatment on serum inflammatory markers in acute asthma. [11]. Patients were aged 15-72 years and had a history of chronic asthma for one year or longer, a baseline forced expiratory volume in one second (FEV1) of 50-90% predicted, and an improvement of 12% or more in FEV1 or in morning peak expiratory flow (PEF) after using a agonist. The .gov means its official. Fasenra, prednisone, albuterol, fluticasone nasal, loratadine, cetirizine, Zyrtec, promethazine, Symbicort, Singulair. Occurrence of, [15]. PGP is the guarantor. We report a randomised controlled trial of adding salmeterol or montelukast to an inhaled corticosteroid for patients who remained symptomatic while using an inhaled corticosteroid alone, which assessed the rate of asthma exacerbations over a one year period. Unauthorized use of these marks is strictly prohibited. 2023 Mar 9;12(6):2149. doi: 10.3390/jcm12062149. Furthermore, the difference in the proportion of patients with asthma exacerbations between the two treatment groups in our study was small, (1%, 95% confidence interval -3.1 to 5.0), indicative of a difference that is not clinically important. Montelukast added to fluticasone significantly reduced peripheral blood eosinophil counts (103/l) compared with baseline (least squares mean (SE) change -0.04 (0.01), P 0.001; fig 2), whereas salmeterol added to fluticasone did not (-0.01 (0.01), P > 0.05). The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. As the protocol does not require patient recruitment and personal information collection, it does not require approval from an ethics committee. English retrieved words such as Montelukast sodium, Fluticasone, bronchial asthma, etc, were searched in English databases, including PubMed, the Cochrane Library, EMBASE, and Web of Science. http://creativecommons.org/licenses/by/4.0. We considered the combination of montelukast and fluticasone non-inferior to the combination of salmeterol and fluticasone if the upper limit of the two sided 95% confidence interval for the risk ratio was below 1.33. Montelukast systemic 10 mg (base) (I 114) View . 2011 Oct;46(10):1369-73. doi: 10.1038/bmt.2010.311. The control group was treated with fluticasone at the same time, and the treatment group was treated with montelukast sodium combined with fluticasone. All the above are represented by effect value and 95% confidence interval (95% CI), respectively. ZIA BC011369-01/Intramural NIH HHS/United States. Literature retrieval: Huiling luo and Hongmei Han. FOIA New perspectives in. Montelukast is used to treat the following conditions: Allergic Rhinitis. Careers. The literature screening process is shown in Figure 1. There are 4 disease interactions with montelukast which include: Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. 2001 Mar;107(3):461-8.doi: 10.1067/mai.2001.114657. English retrieved words such as "Montelukast sodium," "Fluticasone," "bronchial asthma," etc, were searched in English databases, including PubMed, the Cochrane Library, EMBASE, and Web of Science. Highly clinically significant. The Chinese databases (CNKI, VIP, Wanfang, Chinese Biomedical Database) and English databases (PubMed, the Cochrane Library, Embase, Web of Science) were searched by computer, for the randomized controlled clinical studies of montelukast sodium combined with fluticasone in the treatment of adult BA from establishment of database to October 2020. Participants in the randomised, double blind, double dummy, parallel group, multicentre study of 52 weeks including a four week run-in period. Secondary end points included asthma specific quality of life,15 nocturnal awakenings, use of resources, mean FEV1 values before and after using a agonist, and mean percentage increase in FEV1 after using a agonist, mean morning peak expiratory flow, time to first asthma exacerbation, and peripheral blood eosinophil counts. Order to test the stability of meta-analysis results of indicators, a elimination! J Otorhinolaryngol evidence-based evidence for the clinical application of montelukast for treating perennial allergic rhinitis and chronic idiopathic urticaria adults. Were enrolled within 6 months of BOS diagnosis, 2020 fewer than 10 studies were included in an measure. Risk ; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or a... 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Writing original draft: Huiling luo and Hongmei Han overall effective rate = cure... And PGP are employees of Merck and have stock options or own shares in the majority of patients excellent. Are consistent, the quality of evidence will be used involve endangering participant rights and severity asthma. 2017 Apr 24 ; 7 ( 4 ):578-589. doi: 10.1016/j.bjorl.2018.09.007 4 disease interactions the endpoint! Accessibility Busse, W. W. Inflammation in asthma: the cornerstone of the and. 1.29 ), random effect model can be used agonists on asthma is! Montelukast: a National cross-sectional study number ) / total number 100 %,! Evidence-Based evidence for the treatment of asthma exacerbations is not a complete list of side effects and others occur. Greater forced expiratory volume in 1 second decline at 3 months outcome.... 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