[The effectiveness of leukotriene antagonists in the treatment of aspirin-intolerant asthmatic patients].
BACKGROUND
The aim of this study was to assess the efficacy of leucotrien- antagonists in aspirin-intolerant asthma (AIA). The severity of asthma was evaluated according to GINA guidelines. On each consultation, the patients filled-in a simplified self-assessment questionnaire on rhinitis and quality of life (QOL).


METHODS
Montelukast was administered during the inclusion visit. Patients' general state of health was assessed, FEV1 and MMEF25-75 were measured and the QOL and rhinitis scores and therapeutic impact were analysed at 3 and 6 months.


RESULTS
Sixteen patients were included. FEV1 was initially recorded at 62% +/- 23 of theoretical values and then improved to 73% +/- 26.8 (p<0.002), and 77.2% +/- 17. Initial rhinitis score was 13 +/- 3.7 then 9 +/-5 (p<0.006) and 5.7 +/- 3.5 (p<0.03). Oral corticosteroids were required in 12 patients (8.5 +/- 5.6 mg). This dose was tapered to 3.4 +/- 6.4 mg (p<0.04) and 2.1 +/- 4.4 mg and stopped in 8 patients. The initial QOL score was of 4.36 +/- 1.4 and improved to 5.87 +/- 1.06 (p<0.002), and to 5.90 +/- 1.12.


CONCLUSIONS
Aspirin-induced asthma is a challenging issue. Rhinitis is a major feature of discomfort. Following montelukast administration, we noted an improvement in the QOL and rhinitis subjective parameters, and an objective improvement in spirometrical measurements and in the doses of oral corticosteroids.


CONCLUSIONS
Early recognition of these asthmatic patients is required in order to optimise their management. Administration of montelukast could be envisaged as unofficial first-line therapy in these patients combined with the recommended treatments.
Paganin
Fabrice
F
Unité de consultation, service de réanimation. CHD Félix Guyon, St Denis de la Réunion (97). f.paganin@wanadoo.fr
Poubeau
Patrice
P
Yvin
Jean-Luc
JL
Arvin-Berod
Claude
C
D000085:Acetates / Q000627:therapeutic use*; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D001241:Aspirin / Q000009:adverse effects*; D001249:Asthma / Q000175:diagnosis / Q000188:drug therapy*; D001760:Bleeding Time; D003521:Cyclopropanes; D005260:Female; D006801:Humans; D020024:Leukotriene Antagonists / Q000627:therapeutic use*; D008297:Male; D011788:Quality of Life; D011804:Quinolines / Q000627:therapeutic use*; D012220:Rhinitis / Q000175:diagnosis; D012720:Severity of Illness Index; D013147:Spirometry / Q000379:methods; D013440:Sulfides; D011795:Surveys and Questionnaires
D000085:Acetates; D000894:Anti-Inflammatory Agents, Non-Steroidal; D003521:Cyclopropanes; D020024:Leukotriene Antagonists; D011804:Quinolines; D013440:Sulfides; C093875:montelukast; D001241:Aspirin