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Tailored second line therapy in asthmatic children with the arginine-16 genotype
journal contribution
posted on 2023-06-08, 14:03 authored by Brian J Lipworth, Kaninika Basu, Helen P Donald, Roger Tavendale, Donald F Macgregor, Simon A Ogston, Colin N A Palmer, Somnath MukhopadhyaySomnath MukhopadhyayThe arginine-16 beta-2 receptor genotype confers increased susceptibility to exacerbations in asthmatic children taking regular long acting beta-2 agonists. We therefore evaluated using montelukast as an alternative to salmeterol as tailored second line asthma controller therapy in children expressing this susceptible genotype. 62 persistent asthmatic children with the homozygous arginine-16 genotype were randomized to receive salmeterol 50ug bid or montelukast 5/10mg od as add on to inhaled fluticasone for 1 year. School absences (the primary outcome) were reduced with montelukast arm compared to salmeterol: difference in score = 0.40 (95%CI 0.07-0.87) p=0.005. Albuterol use was also reduced with montelukast compared with salmeterol: difference in score = 0.47 (95%CI 0.16-0.79) p<0.0001. Greater improvements occurred in both symptom and quality of life scores with montelukast vs salmeterol, while there was no difference in FEV1. Montelukast may be suitable as tailored second line controller therapy instead of salmeterol in asthmatic children expressing the susceptible arginine-16 genotype - moving towards a personalised medicine approach to management.
History
Publication status
- Published
File Version
- Accepted version
Journal
Clinical ScienceISSN
0143-5221Publisher
Portland PressExternal DOI
Issue
8Volume
124Page range
521-528Department affiliated with
- Clinical and Experimental Medicine Publications
Notes
Online first publicationFull text available
- Yes
Peer reviewed?
- Yes
Legacy Posted Date
2013-01-08First Open Access (FOA) Date
2013-05-05First Compliant Deposit (FCD) Date
2013-01-08Usage metrics
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