Effect of Montelukast on the Symptom Severity Score of Allergic Rhinitis

Abstract

Introduction Rhinitis is a common respiratory disorder that can be broadly defined as an inflammation of nasal mucosa. Allergic rhinitis is the most common form of chronic rhinitis characterized by one or more symptoms including sneezing, nasal itching, nasal congestion, postnasal drip, and rhinorrhea. Montelukast is an antagonist to the leukotriene receptor. It is non-sedating, dosed once daily, and has a safety profile similar in adults and children, with approval down to six months of age. The purpose of the study was to see the improvement in the severity of symptoms of the patients with allergic rhinitis treated with montelukast. Methods The symptom severity score for allergic rhinitis was calculated by asking the patient to evaluate the severity of individual symptoms (sneezing, nasal congestion, rhinorrhea, and postnasal drip) against the 4-point scoring scale over the last 24 hours. After explaining the scoring system to the patient, a proforma was filled before starting the treatment. A dose of 10 mg of montelukast once daily was prescribed. On the follow-up visit after four weeks of therapy, compliance was ensured and then the symptom severity score was recorded again on the proforma. The total nasal symptom severity score (TNSSS) was calculated as a sum of all four nasal symptoms. Pre-and post-treatment mean of TNSSS was compared using a t-test. P-value of less than 0.05 was considered significant. Results A total of 140 patients were included in the study. The mean age was 30 years. The minimum age was 15 years and the maximum age was 45 years. There were 93 males and 47 females. The difference between pre-and post-mean values of TNSSS was 5.82. Both pre-and post-mean of TNSSS were compared using the t-test, and P-value was significant, i.e., <0.005. Conclusions The common symptoms of allergic rhinitis evaluated in the study showed improvement in response to the treatment with montelukast. The improvement in symptom severity score was maximum in sneezing and least in rhinorrhea. In light of recent developments on neuropsychiatric adverse effects and FDA warnings, caution needs to be exercised to reserve the

efficacy and prevalence of montelukast therapy in patients with allergic rhinitis

“…The effects of Montelukast are on the function of cysteinyl leukotriene receptor 1, which is located in inflammatory cells including smooth muscle cells, and endothelial cells in the mucosa of both the upper and the lower respiratory tracts [2]. Young adults are commonly affected by AR [2], while in this study most patients above age of 40 years.…”

“…The effects of Montelukast are on the function of cysteinyl leukotriene receptor 1, which is located in inflammatory cells including smooth muscle cells, and endothelial cells in the mucosa of both the upper and the lower respiratory tracts [2]. Young adults are commonly affected by AR [2], while in this study most patients above age of 40 years. A randomized, placebo-controlled, 32-week study on patients with AR without the associated respiratory disease compared antihistamine treatment alone or in combination with Montelukast.…”

“…It is defined as common respiratory disorder presented as an inflammation of nasal mucosa. It is the most common form of chronic rhinitis characterized by one or more symptoms including sneezing, nasal itching, nasal congestion, postnasal drip, and rhinorrhea [2]. It is affecting the nose and nasal passages, and may also represent a component of a systemic disease reach frequently the lower respiratory tract as well [3].…”

“…It is non-sedating, dosed once daily, and has a safety profile same as in adults and children with approval down to 6 months of age [1]. Its benefit is equivalent to antihistamines when used as monotherapy, but less than intranasal corticosteroids [2]. The aim of this work was to identify the improvement in the severity of symptoms of child with AR treated with Montelukast.…”