Montelukast and Neuropsychiatric Events in Children with Asthma: A Nested Case–Control Study

Glockler-Lauf, S. Dresden; Finkelstein, Yaron; Zhu, Jingqin; Feldman, Laura; To, Teresa

doi:10.1016/j.jpeds.2019.02.009

Cited by 67 publications

(64 citation statements)

References 18 publications

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“…[42][43][44] A recent nested case-control study of 898 cases and 3,497 con trols from a cohort of children with asthma aged 5-18 years in 2004-2015 reported that children who were prescribed montelukast had increased odds (2 times) of experiencing a neuropsychiatric event. 45) However, 2 recent systematic reviews on this issue reported that the association between neuropsychiatric events and montelukast use was reported by studies using pharmacovigilance databases and not by observational or cohort studies. 46,47) A study assessing a cohort of 670 adults with allergic rhinitis in Spain reported that the severity of allergic rhinitis was related to a worse quality of life, sleep disturbances, depression, and anxiety.…”

Section: Safety Profilementioning

confidence: 99%

“…Many studies that have analyzed published case reports or databases of adverse drug response reporting systems suggested that montelukast use is associated with neuropsychiatric events such as anxiety, sleep disturbance, depression, and suicidality [ 42 - 44 ]. A recent nested case-control study of 898 cases and 3,497 con trols from a cohort of children with asthma aged 5–18 years in 2004–2015 reported that children who were prescribed montelukast had increased odds (2 times) of experiencing a neuropsychiatric event [ 45 ]. However, 2 recent systematic reviews on this issue reported that the association between neuropsychiatric events and montelukast use was reported by studies using pharmacovigilance databases and not by observational or cohort studies [ 46 , 47 ].…”

Section: Safety Profilementioning

confidence: 99%

See 1 more Smart Citation

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: Safety Profilementioning

confidence: 99%

Section: Safety Profilementioning

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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“…(64) The recommended daily dose of montelukast is 4 mg for asthma patients from 2 to 5 years of age, 5 mg for those from 6 to 14 years of age, and 10 mg for those ≥ 15 years of age. (65,66)…”

Section: Montelukastmentioning

confidence: 99%

2020 Brazilian Thoracic Association recommendations for the management of asthma

et al. 2020

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The pharmacological management of asthma has changed considerably in recent decades, as it has come to be understood that it is a complex, heterogeneous disease with different phenotypes and endotypes. It is now clear that the goal of asthma treatment should be to achieve and maintain control of the disease, as well as to minimize the risks (of exacerbations, disease instability, accelerated loss of lung function, and adverse treatment effects). That requires an approach that is personalized in terms of the pharmacological treatment, patient education, written action plan, training in correct inhaler use, and review of the inhaler technique at each office visit. A panel of 22 pulmonologists was invited to perform a critical review of recent evidence of pharmacological treatment of asthma and to prepare this set of recommendations, a treatment guide tailored to use in Brazil. The topics or questions related to the most significant changes in concepts, and consequently in the management of asthma in clinical practice, were chosen by a panel of experts. To formulate these recommendations, we asked each expert to perform a critical review of a topic or to respond to a question, on the basis of evidence in the literature. In a second phase, three experts discussed and structured all texts submitted by the others. That was followed by a third phase, in which all of the experts reviewed and discussed each recommendation. These recommendations, which are intended for physicians involved in the treatment of asthma, apply to asthma patients of all ages.

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“…Common side effects include diarrhea, nausea, vomiting, mild rashes, asymptomatic elevations in liver enzymes and fever. In 2019 and 2020, concerns for neuropsychiatric reactions were added to the label in the UK and US where the most frequently suspected were nightmares, depression, insomnia, aggression, anxiety and abnormal behavior (Glockler-Lauf et al, 2019).…”

Section: Montelukastmentioning

confidence: 99%

Montelukast Drug May Improve COVID-19 Prognosis: A Review of Evidence

Barre¹,

Sabatier

Annweiler

2020

Front. Pharmacol.

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With the lack of effective therapy, chemoprevention and vaccination, focusing on the immediate repurposing of existing drugs gives hope of curbing the pandemic. Interestingly, montelukast, a drug usually used in asthma, may be proposed as a potential adjuvant therapy in COVID-19. The aim of the present article was to review the properties of montelukast that could be beneficial in COVID-19. Ten experimentally supported properties were retrieved, either related to SARS-CoV-2 (antiviral properties, prevention of endotheliitis and of neurological disorders linked to SARS-CoV-2), and/or related to the host (improvement of atherogenic vascular inflammation, limitation of the ischemia/reperfusion phenomenon, improvement of respiratory symptoms), and/or related to serious COVID-19 outcomes (limitation of the cytokine storm, mitigation of acute respiratory distress syndrome), and/or related to tissue sequelae (antioxidant properties, anti-fibrosis effects). Based on gathered theoretical evidence, we argue that montelukast should be further tested to prevent and treat COVID-19 outcomes.

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Montelukast and Neuropsychiatric Events in Children with Asthma: A Nested Case–Control Study

Cited by 67 publications

References 18 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

2020 Brazilian Thoracic Association recommendations for the management of asthma

Montelukast Drug May Improve COVID-19 Prognosis: A Review of Evidence

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