Reduction of Eosinophilic Inflammation in the Airways: Sputum Eosinophils

Montelukast decreased the mean percentage of sputum eosinophils from 24.6 ± 12.3% at baseline to 15.1 ± 11.8% at the end of the treatment period, resulting in a change of — 9.5 ± 12.7% (p < 0.005). In contrast, placebo treatment decreased the mean percentage of sputum eosinophils from 21.3 ± 12.1% at baseline to 21.0 ± 11.5% at the end of the treatment period, resulting in a change of — 0.3 ± 10.8%. The reduction in the percentage of sputum eosinophils was significantly greater in the montelukast period than in the placebo period (p < 0.005, Fig 2). Because this parameter showed a significant period effect, analysis was also performed using the data in period 1 only. The reduction in the percentage of sputum eosinophils was again significantly greater in the montelukast period than in the placebo period (p < 0.005, data not shown).
Peripheral Blood Eosinophils
Because baseline values were not measured in period 2, the posttreatment values in each period were compared directly. Canadian drug mall The mean baseline number of peripheral blood eosinophils was 439.7 ± 223.5/mL. The value after montelukast treatment (314.1 ± 237.6/mL) was significantly different from the value after placebo administration (413.1 ± 232.1/mL; p < 0.005; Fig 3). These results demonstrate that treatment with montelukast resulted in a significantly lower number of peripheral blood eosinophils.
PEF
Morning PEF increased significantly with mon-telukast treatment from 427.7 ± 98.3 L/min at baseline to 444.4 ± 97.9 L/min (p < 0.005) at 2 weeks of treatment, and to 448.6 ± 97.9 L/min (p < 0.0005) at 4 weeks of treatment, resulting in mean increases of 16.7 ± 19.7 L/min and 20.9 ± 19.6 L/min, respectively. No significant change in morning PEF was observed during the placebo period. Morning PEF changed from 426.9 ± 95.0 L/min at baseline to 429.4 ± 90.6 L/min (not significant [NS] vs baseline) at 2 weeks, and to 437.5 ± 103.6 L/min (NS vs baseline) at 4 weeks, resulting in mean increases of 2.5 ± 18.7 L/min and 10.6 ± 31.9 L/min, respectively. There was no statistically significant difference in the extent of change from baseline in morning PEF between mon-telukast and placebo at 4 weeks (Fig 4).
Fig2
Figure 2. The effects of montelukast compared with placebo treatment on the percentage of sputum eosinophils during the 4-week treatment period. Points shows the percentage changes in the individual patients.
fig3
Figure 3. The effects of montelukast compared with placebo treatment on peripheral blood eosinophils during the 4-week treatment period. Values are mean peripheral blood eosinophil counts (SD).
Fig4
Figure 4. The effects of montelukast compared with placebo on morning (Top, A) and evening PEF (bottom, B). Values are mean ± SD. The values are presented as the mean change from baseline (SD). fp < 0.01 compared with baseline. *p < 0.05 compared with placebo.

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