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If as-needed inhaled β-agonists fail to control asthma symptoms, guidelines generally recommend the addition of inhaled corticosteroids. However, the new and heavily marketed leukotriene modifiers may represent an orally administered alternative. These researchers compared inhaled steroid therapy and therapy with the leukotriene receptor antagonist montelukast in a double-blind, randomized 24-week trial, supported by the maker of fluticasone.
A total of 533 adults and adolescents with persistent asthma (FEV1, 50 percent to 80 percent of predicted, with at least 15 percent improvement after inhaled albuterol) received either inhaled fluticasone (88 μg twice daily) plus oral placebo, or oral montelukast (10 mg once daily) plus inhaled placebo.…