Montelukast and improvement of eczema: observations from a prescription event monitoring study in England.
OBJECTIVE
Montelukast is an orally administered cysteinyl receptor antagonist, approved for the treatment of asthma. There is pharmacological plausibility of its effectiveness in the treatment of other immunologically mediated conditions such as eczema and urticaria. The objective of this study was to determine whether there are any beneficial effects of montelukast on eczema and urticaria.


METHODS
A non-interventional observational cohort study was conducted between February 1998 and December 1998 using Prescription-Event Monitoring (PEM). During PEM studies, patients are systematically identified from dispensed prescription data and questionnaires are sent to the prescribing general practitioner (GP) asking them to report events occurring during and after treatment. In this study, events reported as eczema or urticaria improved were identified. A simple questionnaire was sent to the GPs for additional information.


RESULTS
The cohort comprised 15,612 patients, in which 16 reports of eczema or urticaria improved were identified. Questionnaires were sent to the GPs for additional information. Fifteen of the 16 questionnaires were returned. In 5 cases the GPs thought that there was an improvement of eczema or urticaria with montelukast treatment in patients who had history of longstanding eczema or urticaria. Of the remaining 11 cases there was an alternative explanation for the improvement of eczema or urticaria in 10 cases and one was unassessable.


CONCLUSIONS
PEM is conducted to monitor the safety of medicines, and doctors report events including improvement in pre-existing conditions. Although the number of cases of improvement of eczema or urticaria in this cohort is small, there is a possibility that leukotriene inhibitors may be helpful in the treatment of these diseases. Further studies are needed to provide evidence as to whether montelukast will have a role in the treatment of these conditions.
Biswas
P
P
Drug Safety Research Unit, Southampton, Hants, UK. pipasha.biswas@dsru.org
Wilton
L V
LV
Shakir
S A
SA
D000085:Acetates / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D002648:Child; D015331:Cohort Studies; D003521:Cyclopropanes; D004341:Drug Evaluation; D016903:Drug Monitoring / Q000379:methods; D004485:Eczema / Q000188:drug therapy*; D004739:England; D005260:Female; D006801:Humans; D020024:Leukotriene Antagonists / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011804:Quinolines / Q000627:therapeutic use*; D013440:Sulfides; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014581:Urticaria / Q000188:drug therapy
D000085:Acetates; D003521:Cyclopropanes; D020024:Leukotriene Antagonists; D011804:Quinolines; D013440:Sulfides; C093875:montelukast