Asthma Clinical Trial
Official title:
Randomised, Open-label, Parallel-group Study of Therapeutic Effect of Leukotriene Modulator Montelukast Alone or Combined With Inhaled Corticosteroid on Cough Variant Asthma
This study aims to observe the therapeutic effect of leukotriene modulator montelukast alone
or combined with inhaled corticosteroid(ICS) on cough variant asthma(CVA).
The investigators hypothesize:
1. Cough score and cough reflex sensitivity will be improved after treatment with
montelukast, inhaled corticosteroid/β2 agonist(ICS/LABA), and two combinations.
2. Combination of leukotriene modulator and inhaled corticosteroid/β2 agonist may have
better efficacy when compared to montelukast, corticosteroid/β2 agonist alone while MON,
is comparable to symbicort.
Study groups:
99 patients diagnosed with CVA will be randomised into three groups as follows:
Group 1: inhaled corticosteroid+β2 agonist The patients with cough variant asthma received
Symbicort Turbuhaler (Budesonide 160µg and Formoterol 4.5µg) 1puff Q12h for 8 weeks.
Group 2: montelukast The patients with cough variant asthma received montelukast 10mg QN for
8 weeks, without any other corticosteroid or β2 agonist.
Group 3: montelukast combined with inhaled corticosteroid+β2 agonist The patients with cough
variant asthma received montelukast 10mg QN combined with Symbicort Turbuhaler (Budesonide
160µg and Formoterol 4.5µg) 1puff Q12h for 8 weeks..
The study will be divided into following phases:
1. First Visit (Visit 1, day -6):
A full medical history and physical examination to be undertaken to determine whether
patients meet the inclusion/exclusion criteria.
After the informed consent has been signed, the following samples are obtained from all
patients: blood samples for routine clinical laboratory tests (haematology, biochemistry
and chest x-ray). A urine pregnancy test will be performed in women of childbearing
potential.
Bronchial provocation test by methacholine inhalation are performed to determined the
presence of bronchial non-specific hyper-responsiveness.
Patients are given the Diary Card.
2. Screening Period ( day -6 to day 0, 6 Days) Patients took two medications as bellows for
3 days and followed by 3 days of wash-out period. Patients should completed 6 days diary
card, starting from day -6 to week 0.
Bambuterol HCI (Bambec, brand name), 10 mg qn po Theophylline tablet sustained release,
100mg bid po
3. Second Visit (Visit 2, Week 0):
A physical examination were to be performed. All laboratory tests results are obtained
to determine whether patients meet the inclusion/exclusion criteria. Concurrent
medication were recorded.
The Diary Card were collected, reviewed and assessed whether ICS, bronchodilator or
ICS/BD treatment is efficient for cough symptom (symptom score improved 1 at least).
Capsaicin challenge test and FENO were performed and hypertonic saline induced sputum
samples for cell differential, urine leukotriene, serum IgE, were taken from enrolled
patients.
Enrolled patients were randomized into different groups, and the study medication were
dispensed.
4. During Treatment 1(Week 0 to Week 4, 14 days):
Patients were to take study medication for 28 days and completed Diary Card for 7 days
from Week 3 to Week 4.
5. Third Visit (Visit 3, Week 4):
A physical examination were to be performed. The Diary Card were collected and reviewed.
Adverse events, secondary complications, concurrent medication will be recorded.
Capsaicin challenge test and FENO were performed and hypertonic saline induced sputum
samples for cell differential were taken from enrolled patients.
6. During Treatment 2 (Week 4 to Week 8, 14 days):
Patients were to take study medication for 28 days and completed Diary Card for 7 days
from Week 7 to Week 8.
7. Forth Visit (Visit 4, Week 8):
A physical examination and were to be performed. The Diary Card were collected and reviewed.
Residual (unused) medications were to be returned. Adverse events, secondary complications,
concurrent medication will be recorded.
Capsaicin challenge test and FENO were performed and hypertonic saline induced sputum samples
for cell differential, urine leukotriene, serum IgE, were taken from enrolled patients.
Blood samples for routine clinical laboratory tests (haematology and biochemistry) were
obtained, if a clinically significant laboratory abnormal result was noted at the visit 4, AE
and a follow-up visit would be considered.
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