Montelukast

Muijsers, Richard B.R.; Noble, Stuart

doi:10.2165/00128072-200204020-00005

Cited by 32 publications

(17 citation statements)

References 95 publications

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“…The observed safety and tolerability results are consistent with the safety profile of montelukast previously reported in asthma childhood [2,13,14,22,24-26,37-39]. …”

Section: Discussionsupporting

confidence: 90%

“…Although cross-study comparisons are difficult due to differences in study designs and diversity in efficacy outcomes, the results of the current study are consistent with the efficacy profiles of montelukast in childhood asthma that were previously reported in systematic reviews and randomized clinical trials conducted in preschool [11,13,21,22] and school-aged [11,14,22-28] children. Furthermore, the observed ACQ improvement is significantly higher to that observed with placebo in clinical trials with comparable follow-up schedules to the current study [29,30].…”

Section: Discussionsupporting

confidence: 90%

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Effectiveness of montelukast administered as monotherapy or in combination with inhaled corticosteroid in pediatric patients with uncontrolled asthma: a prospective cohort study

Bérubé

Djandji

Sampalis

et al. 2014

All Asth Clin Immun

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BackgroundAsthma is the most common chronic disease of childhood and a leading cause of childhood morbidity. The aim of the current study was to assess the effectiveness of montelukast administered as monotherapy or in combination with current inhaled corticosteroids (ICS) in pediatric patients with uncontrolled asthma as per the Canadian Asthma Consensus Guidelines.MethodsTwelve-week, multicentre, open-label, observational study. Primary effectiveness outcome was the proportion of patients achieving asthma control (Asthma Control Questionnaire (ACQ) score ≤0.75) at weeks 4 and 12.ResultsA total of 328 patients with uncontrolled asthma (ACQ > 0.75) were enrolled with mean ± SD age of 6.9 ± 3.4 years. Among these, 76 (23.2%) were treated with montelukast monotherapy and 252 (76.8%) with montelukast combined with ICS. By 4 weeks of treatment 61.3% and 52.9% of the patients in the monotherapy and combination group, respectively, achieved asthma control. These proportions increased to 75.0% and 70.9%, respectively, at 12 weeks. Within the monotherapy group, clinically significant improvements in the ACQ score (mean ± SD of 1.67 ± 0.69, 0.71 ± 0.70 and 0.50 ± 0.52 at baseline, 4 and 12 weeks, respectively; p < 0.001) and the PACQLQ score (mean ± SD of 5.34 ± 1.14, 6.32 ± 0.89 and 6.51 ± 0.85 at baseline, 4 and 12 weeks, respectively; p < 0.001) were observed. In the combination group, the mean ± SD ACQ score significantly improved from 2.02 ± 0.83 at baseline to 0.90 ± 0.86 at 4 weeks and 0.64 ± 0.86 at 12 weeks (p < 0.001), while the PACQLQ score improved from 4.42 ± 1.35 at baseline to 5.76 ± 1.30 at 4 weeks and 6.21 ± 1.03 at 12 weeks (p < 0.001). After a 12-week montelukast add-on therapy, 22.6% of patients reduced their ICS dosage. Similar results were observed among preschool- and school-aged patients.ConclusionsMontelukast as monotherapy or in combination with ICS represents an effective treatment strategy for achieving asthma control in pediatric patients and improving caregivers’ quality of life.Trial registrationThis study is registered at ClinicalTrial.gov: NCT00832455.

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“…The observed safety and tolerability results are consistent with the safety profile of montelukast previously reported in asthma childhood [2,13,14,22,24-26,37-39]. …”

Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 90%

Effectiveness of montelukast administered as monotherapy or in combination with inhaled corticosteroid in pediatric patients with uncontrolled asthma: a prospective cohort study

Bérubé

Djandji

Sampalis

et al. 2014

All Asth Clin Immun

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“…[7] We and others previously have reported good clinical response to montelukast in patients with eosinophilic gastroenteritis. [8-11] Vanderhoof and Young reported on eight patients with dysphagia, diarrhea, and/or constipation associated with tissue eosinophilia who had prolonged remission of symptoms with montelukast therapy.…”

Section: Introductionmentioning

confidence: 99%

“…Specifically, the average population elimination t-1/2 for montelukast in our subjects (1.8 hours) was substantially shorter than mean values for this parameter (3.4 hours) determined from children without concurrent intestinal disease. [7,12] While the reasons for this apparent disparity are not clear, it is possible that local montelukast metabolism (i.e. in the small intestine) may vary as a consequence of disease state.…”

Section: Introductionmentioning

confidence: 99%

Montelukast in the treatment of duodenal eosinophilia in children with dyspepsia: Effect on eosinophil density and activation in relation to pharmacokinetics

et al. 2009

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BackgroundWe have previously demonstrated the clinical efficacy of montelukast in a randomized double-blind controlled cross-over trial in patients with dyspepsia in association with duodenal eosinophilia. The mechanism of this clinical response is unknown but could involve a decrease in eosinophil density or activation.MethodsTwenty-four dyspeptic patients 8–17 years of age underwent initial blood sampling and endoscopy with biopsy. Eighteen of these patients had elevated duodenal eosinophil density and underwent repeat blood sampling and endoscopy following 21 days of therapy with montelukast (10 mg/day). The following were determined: global clinical response on a 5-point Lickert-type scale, eosinophil density utilizing H & E staining, eosinophil activation determined by degranulation indices on electron microscopy, and serum cytokine concentrations. On day 21, pharmacokinetics and duodenal mucosal drug concentrations were determined.ResultsEighty-three percent of the patients had a positive clinical response to montelukast with regard to relief of pain with 50% having a complete or nearly complete clinical response. The response was unrelated to systemic drug exposure or to mucosal drug concentration. Other than a mild decrease in eosinophil density in the second portion of the duodenum, there were no significant changes in eosinophil density, eosinophil activation, or serum cytokine concentrations following treatment with montelukast. Pre-treatment TNF-α concentration was negatively correlated with clinical response.ConclusionThe short-term clinical response to montelukast does not appear to result from changes in eosinophil density or activation. Whether the effect is mediated through specific mediators or non-inflammatory cells such as enteric nerves remains to be determined.Trial RegistrationClinicalTrials.gov; NCT00148603

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“…The onset of action of MLK is rapid as significant improvements in daytime symptoms are recorded within 1 day. Clinical trials data suggest that MLK effectively counteracts exercise-induced bronchoconstriction and provides protection against bronchoconstriction induced by hyperventilation with cold dry air in 3 to 5 year-old children [77]. …”

Section: Discussionmentioning

confidence: 99%

Montelukast versus inhaled corticosteroids in the management of pediatric mild persistent asthma

Scaparrotta

Pillo

Attanasi

et al. 2012

Multidiscip Respir Med

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International guidelines recommend the use of inhaled corticosteroids (ICSs) as the preferred therapy, with leukotriene receptor antagonists (LTRAs) as an alternative, for the management of persistent asthma in children. Montelukast (MLK) is the first LTRA approved by the Food and Drug Administration for the use in young asthmatic children.Therefore, we performed an analysis of studies that compared the efficacy of MLK versus ICSs. We considered eligible for the inclusion randomized, controlled trials on pediatric populations with Jadad score > 3, with at least 4 weeks of treatment with MLK compared with ICS.Although it is important to recognize that ICSs use is currently the recommended first-line treatment for asthmatic children, MLK can have consistent benefits in controlling asthmatic symptoms and may be an alternative in children unable to use ICSs or suffering from poor growth. On the contrary, low pulmonary function and/or high allergic inflammatory markers require the corticosteroid use.

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Montelukast

Cited by 32 publications

References 95 publications

Effectiveness of montelukast administered as monotherapy or in combination with inhaled corticosteroid in pediatric patients with uncontrolled asthma: a prospective cohort study

Effectiveness of montelukast administered as monotherapy or in combination with inhaled corticosteroid in pediatric patients with uncontrolled asthma: a prospective cohort study

Montelukast in the treatment of duodenal eosinophilia in children with dyspepsia: Effect on eosinophil density and activation in relation to pharmacokinetics

Montelukast versus inhaled corticosteroids in the management of pediatric mild persistent asthma

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