Abstract
Background: Asthma is a heterogeneous disease, usually characterized by chronic airway inflammation. It is defined by the history of recurrent respiratory symptoms such as wheeze, shortness of breath, chest tightness and cough that vary over time and in intensity, together with variable expiratory airflow limitation.
 Aim: To compare the clinical efficacy of oral montelukast with inhaled budesonide as controller medication in mild persistent childhood asthma.
 Methods: 54 Children of both genders aged 3 to 12 years, diagnosed as mild persistent childhood asthma in OPD and in pediatric indoor admissions at the tertiary care Hospital in Mumbai were enrolled in this randomized prospective parallel-group comparative study. 28 (51.9%) patients of group A were started on Oral montelukast & 26 (48.1%) of group B were started on inhaled budesonide.
 Results: Amongst patients of Group A, 9 were asymptomatic & 19 were symptomatic at 4 weeks of treatment.10 were asymptomatic & 18 were symptomatic at 3 months of treatment. P-Value was 0.09 suggesting no significant change/improvement in control of asthma symptoms at 3months than at 4 weeks in children treated with oral montelukast. Out of 26 patients of Group B, 6 were asymptomatic & 20 were symptomatic at 4 weeks of treatment. 17 were asymptomatic & 9 were symptomatic at 3 months of treatment. P-Value was 0.046 suggesting a statistically significant improvement in control of asthma symptoms at 3 months than at 4 weeks in children treated with inhaled budesonide.
 Conclusion: More children on inhaled budesonide were controlled on their asthma symptoms, required significantly less reliever medications, had lesser episodes of night awakening due to asthma symptoms and had improvement in their day-time symptoms and activity than those on oral montelukast.
Highlights
Asthma is a heterogeneous disease, usually characterized by chronic airway inflammation
In patients on inhaled budesonide, the day and night-time symptoms were relieved to a similar extent as in patients on montelukast, but the need for relievers was much less and improvement in activity was much more in patients on inhaled budesonide at 4 weeks of follow-up
More significant improvement in asthma attacks/symptoms were seen in patients on inhaled budesonide than those on oral montelukast
Summary
Asthma is a heterogeneous disease, usually characterized by chronic airway inflammation. Aim: To compare the clinical efficacy of oral montelukast with inhaled budesonide as controller medication in mild persistent childhood asthma. P-Value was 0.09 suggesting no significant change/improvement in control of asthma symptoms at 3months than at 4 weeks in children treated with oral montelukast. P-Value was 0.046 suggesting a statistically significant improvement in control of asthma symptoms at 3 months than at 4 weeks in children treated with inhaled budesonide. Conclusion: More children on inhaled budesonide were controlled on their asthma symptoms, required significantly less reliever medications, had lesser episodes of night awakening due to asthma symptoms and had improvement in their daytime symptoms and activity than those on oral montelukast
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