Efficacy and tolerability of basic treatment with montelukast and fluticasone propionate in school-age children with asthma combined with allergic rhinitis

Conducting post-marketing studies to study the effectiveness and safety of the use of leukotriene antagonists, in particular montelukast, in alternative treatment regimens for children with comorbid asthma remains important for personalized therapy. Aim - to study the effectiveness and tolerability of basic therapy with the use of montelukast 5 mg and fluticasone propionate 125 mcg in children with comorbid mild asthma and comorbid moderate asthma, combined with mild persistent allergic rhinitis (AR). Materials and methods. The clinical effectiveness and tolerability of two basic treatment regimens were prospectively analyzed: montelukast 5 mg monotherapy (group I, n=28, patients with mild asthma and RA) and combined use with fluticasone propionate 125 mcg per day (group II, n=20, patients with moderate asthma and mild persistent AR) for 12 weeks in children aged 6-11 years. The controllability of asthma symptoms was assessed using the validated Children's Asthma Control Test (C-AСT) questionnaire, and the symptoms of asthma were assessed using the visual analog scale (VAS). Results. Basic therapy with the use of montelukast had a positive effect on the controllability of asthma and AR symptoms in the both groups of children, which was evidenced by a probable (p=0.000) increase in the C-AСT test index with a higher score in children of the II group (p=0.006). Against the background of treatment, the total VAS index in children of the groups I and II decreased by 2.8 times. Monitoring of adverse events against the background of treatment in the studied groups of children testified to the good tolerability of the applied treatment regimens. Only 1 (3.6%) child of the group I had minor abdominal pain. Conclusions. Monotherapy with montelukast and combined use with fluticasone propionate effectively controls the symptoms of mild and moderate asthma combined with mild persistent RA in children, and is well tolerated. The study was carried out in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Committee on bioethics and deontology of these institutions. The informed consent of the children's parents was obtained for the research. No conflict of interests was declared by the authors.