Effect of montelukast and fluticasone propionate on airway mucosal blood flow in asthma

Asthma is associated with an increase in airway blood flow (Q̇aw), presumably as a manifestation of airway inflammation. We therefore determined the effect of the antiinflammatory agents montelukast (ML) and fluticasone propionate (FP) on Q̇aw in 12 patients with mild intermittent asthma. Using a double-blind approach, Q̇aw along with FEV₁ and V̇max ₅₀ were determined before and after a 2-week treatment period with either ML (10 mg/day), FP (440 μg/day), or 10 mg of ML plus 440 μg of FP daily, separated by 2-week washout periods. Mean (± SEM) Q̇aw ranged from 68 ± 4.2 to 71.8 ± 5.9 μl·minute ^-1·ml^-1 anatomic dead space before the treatment periods. ML, FP, and ML plus FP decreased mean Q̇aw by 21.5, 20.8, and 26.9%, respectively (p < 0.05 for all). No significant difference was observed among the three regimens. FEV₁ and V̇max₅₀ were not changed by any of the treatments. We conclude that at the dosages used, ML and FP are equipotent in reducing Q̇aw in patients with mild asthma, and that the magnitude of the response is not greater if the two drugs are combined. The results also suggest that the vascular effects of these agents can be assessed independent of their effects on airway function.