Trial reportBMC pulmonary medicine2025
Comparison of ICS dose reduction vs. montelukast discontinuation for step-down therapy in well-controlled asthma: a pilot randomized controlled trial.
Trial report in BMC pulmonary medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
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Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWhile asthma guidelines advocate for reducing inhaled corticosteroid (ICS) doses in well-controlled patients, limited evidence exists to directly support this approach. This study aimed to compare the effectiveness of ICS dose reduction versus montelukast discontinuation as step-down strategies in adults with well-controlled asthma.
methodsThis single-center, pilot randomized controlled trial enrolled 73 adults with well-controlled asthma. Participants were randomized to either Group A: ICS Dose Reduction (n = 37) or Group B: Montelukast Discontinuation (n = 36). Both groups received standard care and their designated intervention for three months. The primary outcome was asthma control measured by the ACT score. Secondary outcomes included lung function, asthma exacerbation frequency, treatment failure rates, and cough symptoms. Medication adherence was assessed using dose counters and pill counts.
resultsThere was no significant difference in overall asthma control between the groups, as measured by the ACT score (p = 0.42). However, patients in Group A (reduced ICS) experienced significantly fewer treatment failures compared to Group B (discontinued montelukast) at three months (p = 0.01). No serious adverse events were reported.
conclusionAlthough the ACT scores did not significantly differ between the groups, we did observe a trend towards fewer treatment failures in the ICS reduction group. This suggests that reducing ICS doses may help to maintain asthma control and reduce the risk of exacerbations. However, further research is warranted to confirm these findings in larger, long-term studies.
trial registrationIRCT Registration Number IRCT2016052428037N1, Retrospectively registered, Registration Date 20,160,701.
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