Montelukast does not prevent reactive airway disease in young children hospitalized for RSV bronchiolitis

Proesmans, Marijke; Sauer, Kate; Govaere, Elke; Raes, Marc; Bilderling, Georges de; Boeck, K. De

doi:10.1111/j.1651-2227.2009.01463.x

Cited by 36 publications

(27 citation statements)

References 23 publications

(42 reference statements)

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“…Post hoc analyses of patients with persistent symptoms (SFD ≤ 30% over weeks 1-2) resulted in slight differences in % SDF over weeks 3 to 24 of 5.7 to 5.9 for montelukast (4 or 8 mg/day, respectively) versus placebo groups. A second study in 58 pediatric patients hospitalized with a first episode of RSV bronchiolitis seemed to confirm the conclusions of the previous study, and concluded that montelukast treatment did not reduce symptoms of cough and wheeze (Proesmans et al, 2009). During the three month trial period, no differences between the treatment and control groups were observed for symptom-free days and nights, and during the one year follow-up, no significant differences were observed in the number of exacerbations or time to first exacerbations, number of unscheduled visits and need to start inhaled steroids.…”

Section: Anti-inflammatory Agentssupporting

confidence: 74%

Treatment of Respiratory Syncytial Virus Infection: Past, Present and Future

Roymans¹,

Koul²

2011

Human Respiratory Syncytial Virus Infection

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Section: Anti-inflammatory Agentssupporting

confidence: 74%

Treatment of Respiratory Syncytial Virus Infection: Past, Present and Future

Roymans¹,

Koul²

2011

Human Respiratory Syncytial Virus Infection

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“…For example, in an experimental rhinovirus infection model, montelukast had no effect upon rhinovirus-induced colds or asthma symptoms [88]. Montelukast has also been found not to affect respiratory symptoms after RSV bronchiolitis [89,90], or the incidence of upper respiratory tract infections [91].…”

Section: Leukotriene Receptor Antagonistsmentioning

confidence: 99%

Viral infections and asthma: an inflammatory interface?

et al. 2014

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Asthma is a chronic inflammatory disease of the airways in which the majority of patients respond to treatment with corticosteroids and b 2 -adrenoceptor agonists. Acute exacerbations of asthma substantially contribute to disease morbidity, mortality and healthcare costs, and are not restricted to patients who are not compliant with their treatment regimens. Given that respiratory viral infections are the principal cause of asthma exacerbations, this review article will explore the relationship between viral infections and asthma, and will put forward hypotheses as to why virus-induced exacerbations occur. Potential mechanisms that may explain why current therapeutics do not fully inhibit virus-induced exacerbations, for example, b 2 -adrenergic desensitisation and corticosteroid insensitivity, are explored, as well as which aspects of virus-induced inflammation are likely to be attenuated by current therapy. @ERSpublications Why do virus-induced asthma exacerbations occur? Mechanisms and interventions

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“…Likewise, no significant benefit of montelukast administered both at 4 and 20 weeks after the onset of respiratory symptoms was shown in a large study of infants with post respiratory syncytial virus (RSV) bronchiolitis [48]. A small RCT confirmed this result, showing that montelukast given for three months after hospital admission for RSV bronchiolitis did not reduce the respiratory symptoms during both the treatment and the follow up periods [49]. All these findings appear conflicting with the conclusions of one of the first studies of RSV bronchiolitis that showed that montelukast results in significant improvement of symptoms score and in decrease of nighttime symptoms and daytime cough [50].…”

Section: Scientific Evidences About Ltras In Preschool Childrenmentioning

confidence: 99%

Update on leukotriene receptor antagonists in preschool children wheezing disorders

et al. 2012

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Asthma is the most common chronic disease in young children. About 40% of all preschool children regularly wheeze during common cold infections. The heterogeneity of wheezing phenotypes early in life and various anatomical and emotional factors unique to young children present significant challenges in the clinical management of this problem. Anti-inflammatory therapy, mainly consisting of inhaled corticosteroids (ICS), is the cornerstone of asthma management. Since Leukotrienes (LTs) are chemical mediators of airway inflammation in asthma, the leukotriene receptor antagonists (LTRAs) are traditionally used as potent anti-inflammatory drugs in the long-term treatment of asthma in adults, adolescents, and school-age children. In particular, montelukast decreases airway inflammation, and has also a bronchoprotective effect. The main guidelines on asthma management have confirmed the clinical utility of LTRAs in children older than five years. In the present review we describe the most recent advances on the use of LTRAs in the treatment of preschool wheezing disorders. LTRAs are effective in young children with virus-induced wheeze and with multiple-trigger disease. Conflicting data do not allow to reach definitive conclusions on LTRAs efficacy in bronchiolitis or post-bronchiolitis wheeze, and in acute asthma. The excellent safety profile of montelukast and the possibility of oral administration, that entails better compliance from young children, represent the main strengths of its use in preschool children. Montelukast is a valid alternative to ICS especially in poorly compliant preschool children, or in subjects who show adverse effects related to long-term steroid therapy.

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Montelukast does not prevent reactive airway disease in young children hospitalized for RSV bronchiolitis

Abstract: Treatment with montelukast after hospital admission for RSV bronchiolitis in children younger than 2 years of age did not reduce symptoms of cough and wheeze. We cannot exclude that a subgroup of children may, however, benefit from this treatment.

Cited by 36 publications

References 23 publications

Treatment of Respiratory Syncytial Virus Infection: Past, Present and Future

Treatment of Respiratory Syncytial Virus Infection: Past, Present and Future

Viral infections and asthma: an inflammatory interface?

Update on leukotriene receptor antagonists in preschool children wheezing disorders

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