Comparative Study of Inhaled Corticosteroids and Leukotriene Receptor Antagonists As Controller Options for Mildly to Moderately Persistent, Stable Asthma

Shah J, Siddiqui F, Adnan S, et al. (October 27, 2024) Cureus 16(10): e72490. doi:10.7759/cureus.72490

Abstract

Introduction: Asthma is a chronic inflammatory disease of the airways characterized by bronchoconstriction, airway hyperresponsiveness, and variable airflow limitation. This results in symptoms such as wheezing, difficulty breathing, chest tightness, chest pain, and coughing.

Objectives: The primary objective of the study is to compare the efficacy of inhaled corticosteroids (ICS) versus leukotriene receptor antagonists (LTRA) in improving asthma control, lung function, and quality of life in patients with mild to moderate persistent asthma.

Methodology: This prospective comparative study was conducted at Khyber Teaching Hospital and Dow University Hospital from January 2018 to July 2021. 210 patients suffering from asthma were included in the study. Patients aged 18 years and older, diagnosed with mild to moderate persistent asthma as per Global Initiative for Asthma (GINA) guidelines, and requiring pharmacological intervention were included in the study.

Participants were randomly allocated into two groups. Treatment efficacy was compared based on asthma control (Asthma Control Test (ACT) score), lung function (forced expiratory volume in one second (FEV1), peak expiratory flow rate (PEFR)), and quality of life using validated questionnaires.

Asthma control and lung function parameters

Results: In this study involving 210 patients with asthma, Group A (ICS) had a mean age of 36.23 ± 7.09 years, while Group B (LTRA) had a mean age of 35.23 ± 8.01 years. Both groups exhibited similar baseline asthma control, as indicated by ACT scores of 17.2 ± 3.5 for Group A and 16.8 ± 3.2 for Group B. Significant improvements were observed in both groups at the end of the study, with ACT scores rising to 21.8 ± 2.1 (p < 0.001) for Group A and 20.5 ± 2.5 (p < 0.001) for Group B. Additionally, lung function, measured by FEV1 and PEFR, showed similar enhancements; Group A improved from a baseline FEV1 of 2.5 ± 0.8 L to 3.2 ± 0.6 L (p < 0.01), while Group B improved from 2.4 ± 0.7 L to 3.0 ± 0.5 L. The PEFR values also increased significantly from 300 ± 50 L/min to 380 ± 40 L/min (p < 0.001) for Group A and from 290 ± 45 L/min to 360 ± 30 L/min (p < 0.001) for Group B. Both treatments were well-tolerated, with adverse events being low and comparable between the groups.

Conclusion: This study reveals that both ICS and LTRA significantly improve asthma control, lung function, and quality of life in patients with mild to moderate persistent asthma, with ICS showing superior efficacy. ICS led to greater improvements in ACT scores and lung function parameters, supporting its use as a more effective treatment option in this patient population.

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