Short-course montelukast for intermittent asthma in children: a randomised controlled trial

Colin F. Robertson, David Price, Richard Henry, Craig Mellis, Nicholas Glasgow, Dominic Fitzgerald, Amanda J. Lee, Lane Turner, Melissa Sant

Research output: Contribution to journalArticle

174 Citations (Scopus)

Abstract

Rationale: In children, intermittent asthma is the most common pattern and is responsible for the majority of exacerbations. Mantelukast has a rapid onset of action and may be effective if used intermittently.

Objectives: To determine whether a short course of montelukast in children with intermittent asthma would modify the severity of an asthma episode.

Methods: Children, aged 2-14 years with intermittent asthma participated in this multicenter, randomized, double-blind, placebo-controlled clinical trial over a 12-month period. Treatment with montelukast or placebo was initiated by parents at the onset of each upper respiratory tract infection or asthma symptoms and continued for a minimum of 7 days or until symptoms had resolved for 48 hours.

Measurements and Main Results: A total of 220 children were randomized, 107 to montelukast and 113 to placebo. There were 681 treated episodes (345 montelukast, 336 placebo) provided by 202 patients. The montelukast group had 163 unscheduled health care resource utilizations for asthma compared with 228 in the placebo group (odds ratio, 0.65; 95% confidence interval, 0.47-0.89). There was a nonsignificant reduction in specialist attendances and hospitalizations, duration of episode, and beta-agonist and prednisolone use. Symptoms were reduced by 14% and nights awakened by 8.6% (p = 0.043), and days off from school or childcare by 37% and parent time off from work by 33% (p < 0.0001 for both).

Conclusions: A short course of montelukast, introduced at the first signs of an asthma episode, results in a modest reduction in acute health care resource utilization, symptoms, time off from school, and parental time off from work in children with intermittent asthma.

Original languageEnglish
Pages (from-to)323-329
Number of pages7
JournalAmerican Journal of Respiratory and Critical Care Medicine
Volume175
Issue number4
Early online date16 Nov 2006
DOIs
Publication statusPublished - 15 Feb 2007

Keywords

  • asthma
  • montelukast
  • pediatric
  • leukotriene receptor antagonists
  • double-blind-trial
  • exacerbations
  • childhood

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