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Single corticosteroid inhalers + montelukast (also referred to as Single corticosteroid inhalers and Singulair) is a combination anti-inflammatory treatment regimen evaluated in the NOAK trial (NCT00421018) for the management of allergic asthma in adults. This regimen is not a single fixed-dose combination product but rather a treatment algorithm that combines inhaled corticosteroids (ICS) with montelukast, a leukotriene receptor antagonist (LTRA). Montelukast acts as a selective antagonist of the cysteinyl leukotriene receptor 1 (CysLT1), blocking the bronchoconstrictor and pro-inflammatory effects of leukotriene D4 (LTD4). Inhaled corticosteroids provide broad anti-inflammatory action by binding to glucocorticoid receptors in the airways. Within the trial context, this combination was used in a step-wise approach guided either by fractional exhaled nitric oxide (FeNO) measurements or conventional symptom-based assessments to optimize asthma-related quality of life.
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