title: Montelukast in the treatment of children with moderate-to-severe atopic dermatitis: a pilot study.
abstract: The primary action of leukotrienes includes contraction of human airway muscle, chemotaxis, and increased vascular permeability, with secondary effects of inhibiting allergen-induced early and late responses. Although there is limited available information and research regarding leukotrienes in atopic dermatitis (AD), there is evidence to support their role in the pathogenesis of the disease. We conducted a pilot study to test the efficacy of montelukast, a cysteinyl-leukotriene-1 receptor antagonist, in 15 patients (6-16 years of age) with moderate-to-severe AD, using a randomized double-blind placebo-controlled crossover study. These patients had chronic moderate-to-severe AD, despite being on conventional therapy. They were randomized either to placebo for 4 weeks and then the study drug for 4 weeks, or vice versa. There was a 2-week run-in period for all participants before commencement of the study, and a 2-week washout before crossover. At enrollment and on each follow-up visit, every patient was assessed by a single observer and objectively scored for disease extent and severity. A subjective score was given for the impact of eczema on daily living. There was statistical improvement in patents on active treatment compared with placebo in the severity of AD (p < 0.05). Our findings suggest that leukotriene receptor antagonist as an adjunct treatment has an anti-inflammatory effect on moderate-to-severe AD. A larger trial is needed to ascertain its efficacy fully.
authors.affiliation: Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong. annpei@cuhk.edu.hk
authors.forename: A Y
authors.initials: AY
authors.lastname: Pei
authors.forename: H H
authors.initials: HH
authors.lastname: Chan
authors.forename: T F
authors.initials: TF
authors.lastname: Leung
mesh_terms: D000085:Acetates / Q000627:therapeutic use*; D000203:Activities of Daily Living; D000284:Administration, Oral; D000293:Adolescent; D002648:Child; D003521:Cyclopropanes; D003876:Dermatitis, Atopic / Q000188:drug therapy* / Q000473:pathology; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D020024:Leukotriene Antagonists / Q000627:therapeutic use*; D008297:Male; D010865:Pilot Projects; D011804:Quinolines / Q000627:therapeutic use*; D013440:Sulfides
chemical_list: D000085:Acetates; D003521:Cyclopropanes; D020024:Leukotriene Antagonists; D011804:Quinolines; D013440:Sulfides; C093875:montelukast