A randomized trial of montelukast in respiratory syncytial virus postbronchiolitis.
Infants often develop reactive airway disease after respiratory syncytial virus (RSV) bronchiolitis. Cysteinyl-leukotrienes (cys-LT) are released during RSV infection and may contribute to the inflammation. We hypothesized that a cys-LT receptor antagonist would ameliorate reactive airway disease subsequent to RSV bronchiolitis. One hundred and thirty infants who were 3 to 36 months old, hospitalized with acute RSV bronchiolitis, were randomized into a double-blind, parallel comparison of 5-mg montelukast chewable tablets or matching placebo given for 28 days starting within 7 days of symptom debut. Infants with a suspected history of asthma were excluded. One hundred sixteen infants provided diary card data for the treatment period. Median age was 9 months. Infants on montelukast were free of any symptoms on 22% of the days and nights compared with 4% of the days and nights in infants on placebo (p = 0.015). Daytime cough was significantly reduced on active treatment (p = 0.04). Exacerbations were significantly delayed from montelukast compared with placebo (p < 0.05). In conclusion, cys-LT antagonist treatment reduces lung symptoms subsequent to RSV bronchiolitis.
Bisgaard
Hans
H
Copenhagen Studies on Asthma in Childhood (COPSAC), Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. Bisgaard@copsac.dk
D000085:Acetates / Q000627:therapeutic use*; D001990:Bronchiolitis, Viral / Q000188:drug therapy*; D003521:Cyclopropanes; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007223:Infant; D020024:Leukotriene Antagonists / Q000627:therapeutic use*; D008297:Male; D011804:Quinolines / Q000627:therapeutic use*; D018357:Respiratory Syncytial Virus Infections / Q000188:drug therapy*; D013440:Sulfides
D000085:Acetates; D003521:Cyclopropanes; D020024:Leukotriene Antagonists; D011804:Quinolines; D013440:Sulfides; C093875:montelukast