Fluticasone/Salmeterol Diskus Controls Asthma Better Than Montelukast Sodium in Patients With Both Asthma and Allergic Rhinitis: Presented at CHEST
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Fluticasone/Salmeterol Diskus Controls Asthma Better Than Montelukast Sodium in Patients With Both Asthma and Allergic Rhinitis: Presented at CHEST

By Maggie Schwarz

PHILADELPHIA -- November 2, 2008 -- Patients with the common combination of both rhinitis and asthma would be better off taking one medication for asthma and another for rhinitis, according to researchers presenting here at CHEST 2008, the annual meeting of the American College of Chest Physicians.

"Investigators wanted to compare fluticasone/salmeterol diskus versus montelukast sodium in controlling asthma in patients with both asthma and seasonal allergic rhinitis," explained Thomas J. Ferro, MD, GlaxoSmithKline Research and Development, Research Triangle Park, North Carolina, representing an investigational team led by John Oppenheimer, MD, Pulmonary & Allergy Associates, Summit, New Jersey. Dr. Oppenheimer and his coinvestigators could not attend the poster presentation here on October 29.

The 4-week, randomised, double-blind, triple-dummy, parallel-group trial was undertaken to further evaluate the addition of fluticasone propionate nasal spray, montelukast sodium, or placebo to fluticasone/salmeterol diskus for patients with asthma and allergic rhinitis in subjects with both diseases.

The following 4 treatments were compared:
· Fluticasone/salmeterol diskus plus fluticasone propionate nasal spray plus oral placebo
· Fluticasone/salmeterol diskus plus placebo nasal spray plus montelukast sodium
· Fluticasone/salmeterol diskus plus placebo nasal spray plus oral placebo
· Placebo diskus plus placebo nasal spray plus montelukast sodium

Patients were given an albuterol inhaler to use as needed for asthma symptoms.

Asthma control was determined to be superior for fluticasone/salmeterol diskus compared with montelukast sodium, as demonstrated by a statistically significant and clinically relevant change in the endpoint of morning peak expiratory flow.

Secondary measures of asthma control were all statistically significant, and supported the superiority of asthma control with fluticasone/salmeterol diskus versus montelukast sodium.

Comparisons between fluticasone/salmeterol diskus plus fluticasone propionate nasal spray and fluticasone/salmeterol diskus plus montelukast sodium for seasonal allergic rhinitis also demonstrated statistical superiority favouring fluticasone/salmeterol diskus plus fluticasone propionate nasal spray in terms of total and individual daytime nasal symptom scores.

Adverse events were similar across treatment groups and reports of asthma exacerbations were low.

Funding for this study was provided by GlaxoSmithKline.

[Presentation title: Fluticasone Propionate/Salmeterol via Diskus Is Superior to Montelukast in Overall Asthma Control in Subjects With Both Asthma and Allergic Rhinitis. Abstract AP2243]

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