Asthma Clinical Trial
Official title:
TEAM (Trial on Efficacy and Quality of Life Among Asthmatic Patient With Montelukast)
• To compare the quality of Life using AQLQ (s) questionnaire after 4 weeks of Montelukast.
1.1 Background
Asthma is characterized by airway and lung tissue inflammation and airway hyperresponsiveness
(AHR) that leads to recurrent symptoms of wheezing, breathlessness, chest tightness, and
coughing. AHR indicates an exaggerated response of the airway to nonspecific stimuli, which
results in a temporary airflow limitation, leading to airway obstruction. It remains unknown
which factors within the airway of an individual trigger reversible airway obstruction and
airway narrowing. The airway epithelium is composed of many interacting structural components
and inflammatory cells. The number, activation, and secretory component of inflammatory cells
in the airway are altered in the disease. In asthma, the number of eosinophils and T
lymphocytes is increased in the subepithelial layer.
The impact of asthma has traditionally been measured in terms of the prevalence of the
disease, mortality rates, and levels of healthcare utilisation, particularly hospital
admissions. However, the impact of asthma extends beyond these outcomes to include effects on
lifestyle, wellbeing, and perceived health status. Adults of working age with asthma have
poorer health status and quality of life outcomes than those with no asthma. This effect is
independent of confounding by sociodemographic and life style factors and is evident across a
range of dimensions of quality of life. In comparison with two other chronic health
conditions, asthma has a larger adverse impact on health status and quality of life than
diabetes.
1.2. Investigational Agent
Montelukast reversibly inhibits cysteinyl leukotrienes (CysLTs), specifically leukotrienes D4
(LTD4 [3]. LTD4 is the most potent bronchoconstricting agent on a molar basis, but Cys-LTs
also have chemoattractive properties for many inflammatory cells (mainly eosinophils),
effects on vascular permeability, mucous secretions and sensory nerve activation, and are
responsible for part of the pathophysiology of asthma.
1.3. Dose Rational/Risk & Benefit
Montelukast is a potent and selective blocker of the CysLT1 receptor. For treatment of
chronic asthma, montelukast is administered once daily to adults as a 10-mg film-coated
tablet, to children aged 6-14 years as a 5-mg chewable tablet, and to children aged 2-5 years
as a 4-mg chewable tablet form. Given their efficacy, antiinflammatory activity, oral
administration, and safety, leukotriene modifiers will play an important role in the
treatment of asthmatic patient. Side effects most commonly reported above placebo included
headache, otitis media, upper respiratory infection, and pharyngitis.
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