The effect of ONO-1078 (Pranlukast hydrate), a leukotriene-receptor antagonist, for the treatment of moderate to severe asthmatics with chronic rhinosinusitis / 천식및알레르기

ABSTRACT

BACKGROUND AND OBJECTIVE: The cysteinyl leukotrienes are bioactive lipid mediators that contribute to the pathophysiologic condition of asthma and rhinosinusitis. We tested whether the leukotriene receptor antagonist ONO-1078 (Pranukast) had steroid sparing effect on mode- rate to severe asthmatics with chronic rhinosinusitis. METHODS: Eighteen asthmatic patients with chronic rhinosinusitis who required more than 800 mcg/day of budesonide inhalation for the adequate control of asthma symptoms were recruited for this study. For the first 4 weeks, patients were treated with high dose (800-1200 mcg/day) budesonide inhalation. For the next 4 weeks, the dose of budesonide inhalation was decreased by 400 mcg/day and oral ONO-1078 (900mg/day) was administered. FEV1 was evaluated every 2 weeks, and PC20 on methacholine challenge, serum eosinophil cationic protein and blood eosinophil count were measured every 4 weeks. Diary cards were completed with morning and evening PEFR and symptom scores for asthma and rhinosinusitis during the treatment periods. RESULTS: Despite the reduction of the dose of inhaled corticosteroid by 400mcg/day, FEV1 and PEFR did not decrease with the addition of oral ONO-1078. The symptom scores of asthma and rhino-sinusitis did not change, and the need for beta2-agonist did not increase. CONCLUSION: These results suggest that ONO-1078 might have steroid sparing effect in moderate to severe persistent asthmatics with chronic rhinosinusitis who required high dose nhaled budesonide to control asthma symptoms.