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Asthma guidelines recommend inhaled corticosteroids (ICS) for mild persistent asthma, but many providers and patients prefer leukotriene inhibitors such as montelukast. Two multicenter, randomized, double-blind trials compared once-daily orally administered montelukast and twice-daily inhaled fluticasone.
In a trial sponsored by the manufacturer of montelukast, 925 children with mild persistent asthma (age range, 6–14 years) received montelukast or fluticasone for 12 months. At 1 year, the primary outcome of mean percentage of rescue-free days (days without asthma rescue medication or asthma-related use of health resources) was similar in the two groups (84.0% for montelukast vs. 86.7% for fluticasone). Several secondary endpoints significan…