REPLY
Inhaled Corticosteroids or Antileukotrienes for Asthma?
Theodore F. Reiss, MD
7 December 1999 | Volume 131 Issue 11 | Page 865
IN RESPONSE:
Dr. Hampson suggests that inhaled corticosteroids are a better treatment for asthma than montelukast. Although he correctly points out that, in our study, the mean response of inhaled beclomethasone was larger for some end points, he neglects to mention the important aspect of our analysis: the response distribution. Mean values frequently provide less clinical information than a clear understanding of response distributions. For example, our report clearly demonstrates how these two therapies largely overlap in their response distributions for the FEV1 end point. In addition, with regard to the clinically important outcome of the prevention of worsening asthma episodes (attacks), both therapies significantly differed from placebo and were not different from each other.
With a once-daily oral medication such as montelukast, greater real-world compliance may translate into even greater real-world effectiveness.
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Merck Research Laboratories; Rahway, NJ 07065 (Reiss)
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