Montelukast as an Alternative to Low‐Dose Inhaled Corticosteroids in the Management of Mild Asthma (The SIMPLE Trial): An Open‐Label Effectiveness Trial

Abstract

Montelukast is an effective and well-tolerated alternative to ICS treatment in patients with mild asthma who are uncontrolled or unsatisfied with low-dose ICS therapy.

Influence of leukotriene pathway polymorphisms on clinical responses to montelukast in Japanese patients with asthma

“…Montelukast is a selective cysLT1 receptor antagonist. Anti‐leukotriene drugs such a montelukast are recommended as an alternative to low‐dose inhaled corticosteroids for patients with mild persistent asthma and are recommended as alternative, add‐on (to inhaled corticosteroids) treatment in patients with moderate persistent (step 2) and severe persistent (step 4) asthma for all age groups 12–15 . However, interpatient variability in response to montelukast in both children and adults with asthma is significant, with 35–78% of patients receiving montelukast being classified as non‐responders 16–18 .…”

Oral montelukast compared with inhaled corticosteroid for controlling mild-persistent asthma in Egyptian children and adolescents

“…In contrast, some researchers found out that oral montelukast is an effective well-tolerated monotherapy in controlling mild asthma [32,33].…”

Montelukast for the treatment of asthma in the adult population

“…In 2009, the Singulair Addon Study (SAS) and MONtelukast In Chronic Asthma (MON-ICA) trials and, in 2010, an open-label Austrian study (STAR) reported that the addition of montelukast to ICS monotherapy or ICS and LABA combination therapy resulted in improvement of ACQ and asthma-related quality of life [50][51][52]. In the SIngulair in Mild asthma: ComPLiance and Effectiveness (SIM-PLE) trial by McIvor et al, patients who were not controlled on ICS monotherapy were switched to montelukast monotherapy [53]. The mean number of patients with uncontrolled symptoms over 8 weeks decreased with a significant improvement in ACQ.…”

“…The mean number of patients with uncontrolled symptoms over 8 weeks decreased with a significant improvement in ACQ. Furthermore, it was found that compliance and patient satisfaction increased with montelukast [53]. This suggests that the benefit of montelukast may be underestimated in the clinical trial setting.…”