Early control treatment with montelukast in preschool children with asthma: A randomized controlled trial

Nagao, Mizuho; Ikeda, Masanori; Fukuda, Norimasa; Habukawa, Chizu; Kitamura, Tatsuya; Katsunuma, Toshio; Fujisawa, Takao; Tokuyama, Kennichi; Terada, Akihiko; Sato, Kazuki; Miura, Katsushi; Arakawa, Hirokazu; Zaitsu, Masafumi; Sakamoto, Tastuo; Takamasu, Tetsuya; Shimojo, Naoki; Kameda, Makoto; Mochizuki, Hiroyuki; Tachimoto, Hiroshi; Yamaguchi, Koichi; Masuda, Kenta; Adachi, Yuichi; Oshima, Yusei; Yoshihara, Shigemi; Tanaka, Noriko; Ohta, Kunitaka; Morita, Masao; Tokuda, Reiko; Kitou, Yoshihiko; Araki, Hayao; Yamaoka, Akiko; Nakamura, Akio

doi:10.1016/j.alit.2017.04.008

Cited by 20 publications

(11 citation statements)

References 24 publications

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“…16) However, a recent study compared the efficacy of montelukast maintenance therapy and as-needed β2agonist therapy for 48 weeks in preschool children experiencing asthma symptoms more than once a month but less than once a week. 38) During the study, 28% of the montelukast group and 50% of the no-controller group experienced asthma exacerbations; 21% and 41% of the children, respectively, required increased treatment. Therefore, montelukast use should be considered as maintenance therapy in preschool children with intermittent asthma ( Table 1).…”

Section: Preschool Children With Asthma or Recurrent Wheezingmentioning

confidence: 97%

“…Current clinical practice guidelines recommended controller therapy for children experiencing daytime asthma symptoms more than once a week, with activity limitations, who require the use of a reliever more than once a week, or who have any nighttime symptoms [ 16 ]. However, a recent study compared the efficacy of montelukast maintenance therapy and as-needed β2-agonist therapy for 48 weeks in preschool children experiencing asthma symptoms more than once a month but less than once a week [ 38 ]. During the study, 28% of the montelukast group and 50% of the no-controller group experienced asthma exacerbations; 21% and 41% of the children, respectively, required increased treatment.…”

Section: Clinical Use Of Montelukast In Children With Asthmamentioning

confidence: 99%

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Montelukast use over the past 20 years: monitoring of its effects and safety issues

Lee

Kim

2020

Clin Exp Pediatr

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Montelukast, a leukotriene receptor antagonist, was launched 20 years ago in Korea. It is recommended as an alternative treatment for asthma in children with mild persistent symptoms or as an add-on treatment to existing low-dose inhaled corticosteroids (ICSs) in children who require additional treatment. However, in the real-world setting, many doctors and patients prefer montelukast over ICSs despite their lower efficacy. Although montelukast is considered to be a safe drug, there are concerns regarding adverse drug reactions, including the rare occurrence of Churg-Strauss syndrome and, despite insufficient data, the possibility of neuropsychiatric events such as anxiety, depression, sleep disturbance, and suicidality. This review identified that montelukast has significantly contributed to asthma control over the past 20 years in Korea and has been critical for reducing asthma severity, especially early wheezing and disease control. Our findings suggest that the effects of montelukast treatment can be monitored by measuring serum eosinophilderived neurotoxin levels.

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Section: Preschool Children With Asthma or Recurrent Wheezingmentioning

confidence: 97%

Section: Clinical Use Of Montelukast In Children With Asthmamentioning

confidence: 99%

Montelukast use over the past 20 years: monitoring of its effects and safety issues

Lee

Kim

2020

Clin Exp Pediatr

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“…10 In a study 28% children on montelukast controller therapy had acute exacerbations of asthma. 11 According to a study, combined steroid and montelukast therapy versus only montelukast had same results. 12 In an international study after 8-week treatment, patients who received combined montelukast and inhaled corticosteroid had better outcome in lung function, compared with patients who took only budesonide.…”

Section: Discussionmentioning

confidence: 95%

Comparison of montelukast versus montelukast plus inhaled corticosteroid (Budesonide) in children with mild persistent asthma.

Rai¹,

Chohan

Nazimuddin³

et al. 2021

TPMJ

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Objective: To compare therapeutic response between Montelukast versus Montelukast plus inhaled corticosteroid (Budesonide) in children having mild persistent asthma. Study Design: Randomized Controlled Trial. Setting: Department of Pediatrics Medicine, National Institute of Child Health, Karachi. Period: 1st April 2016 to 30th September 2016. Material & Methods: Children aged 2 years to 14 years having mild persistent asthma for more than 6 months were included. After treatment Good response was considered when, forced expiratory volume in first second (FEV1) became >7.5% from baseline. Group A was given montelukast as monotherapy once daily and Group B was given Montelukast along with inhaled corticosteroid (Budesonide. At 6 weeks followup change in FEV1 was recorded. Result: Mean age of the patients in montelukast alone (Group A) was 6.77+/-2.16 years while in montelukast with Inhaled Corticosteroid (Group B) was 6.97+/-2.17 years. Duration of disease in Group A was 18.32+/-6.12 months while in montelukast with ICS group was 18.50 +/-6.08 months. Baseline FEV1 in Group A was 81.83+/-0.85% while in Group B was 82.05 +/-0.63%. Males were higher with 131 (61.8%). Family history was positive in 82 (38.70%) patients. After 6 weeks mean FEV1 was 89.49 +/-0.87% in Group A while in Group B was 89.53+/-0.86%. Overall good responses were found in 21 (9.09%) patients. In Group A, good response was found in 5 (4.7%) patients while in Group B was in 16 (15.1%) with significant p-value. Conclusion: In our study montelukast along with inhaled steroids had better response than montelukast alone in mild persistent asthma.

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“…Although studies suggested that montelukast could be used at earlier stages of asthma to prevent disease progression, this drug is not preferred as initial therapy [22]. Together with the direct effects of LTRA, alternative anti-in ammatory and anti-brotic properties of montelukast would be useful in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Inflammatory Modulation of Bronchial Epithelial Cells’ Response to Lipopolysaccharide with Pretreatment by Montelukast

Jendrisek

Nikolić

Dragičević

2021

Preprint

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Purpose Montelukast, a leukotriene receptor antagonist, is the most prescribed non-steroidal anti-inflammatory drug used as add-on therapy at later stages of asthma to prevent disease progression. Besides its direct anti-inflammatory effect due to blocking leukotriene action, montelukast has been proposed to have secondary anti-inflammatory and anti-fibrotic properties. This study aimed to investigate the modulatory effect of montelukast on the expression of major genes involved in airway inflammation (TNF, IL6) and remodeling (MMP9, TGFB1) in response to lipopolysaccharide (LPS) in vitro. Methods Effect of montelukast on LPS-induced acute inflammation was analyzed in the immortalized cell line derived from human bronchial epithelium, BEAS-2B. The expression of selected genes was measured by quantitative real-time polymerase chain reaction 0h and 24h after LPS stimulation in cells pretreated with montelukast. Results Montelukast was found to significantly attenuate increased TNF and IL6 gene expression, has a mild effect on MMP9, and has no effect on TGFB1 expression upon stimulation with LPS. Conclusion The results of our study indicate that that patients already using montelukast therapy would have adequate response to acute microorganism-induced inflammation. Additional anti-inflammatory effects of montelukast could be better exploited in clinical practice and modes of montelukast use should be reconsidered to improve the therapeutic approaches in asthma.

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Early control treatment with montelukast in preschool children with asthma: A randomized controlled trial

Abstract: Montelukast is an effective control treatment for preschool children who had asthma symptoms more than once a month but less than once a week.

Cited by 20 publications

References 24 publications

Montelukast use over the past 20 years: monitoring of its effects and safety issues

Montelukast use over the past 20 years: monitoring of its effects and safety issues

Comparison of montelukast versus montelukast plus inhaled corticosteroid (Budesonide) in children with mild persistent asthma.

Inflammatory Modulation of Bronchial Epithelial Cells’ Response to Lipopolysaccharide with Pretreatment by Montelukast

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